| 제목 |
ULTRASONOGRAPHIC EVALUATION IN SUPERFICIAL RADIAL SENSORY NEUROPATHY |
| 소속 |
Korea University Ansan Hospital, Department of Physical Medicine & Rehabilitation1, Korea University, College of Medicine2 |
| 저자 |
Dong Hwee Kim1*†, Young Kwang Choi2, Jong Chan Lim2, Seyoung Shin1 |
Objectives: Superficial radial sensory nerve bifurcates into the medial and lateral branches around the distal forearm and may be injured either at the main trunk, or isolated medial or lateral branch by various etiologies, which is diagnosed by electrophysiological tests. Ultrasonography provide added information in patients with focal nerve injury. However, there was no previous report about the ultrasonographic study of superficial radial sensory neuropathy until now. The purposes of this study are to investigate the clinical utility of ultrasonography in superficial radial sensory neuropathy diagnosed by clinical symptoms and electrodiagnostic studies.
Methods: Twenty-three patients (17 males and 6 females) with superficial radial sensory neuropathy diagnosed by clinical findings, electrodiagnosis, and ultrasonographic examination were retrospectively evaluated. Demographic and clinical characteristics were analyzed using medical records. Patients were divided into three groups according to the lesion locations of superficial radial sensory nerve using clinical findings and electrodiagnostic studies: lateral, medial and both. Ultrasonographic evaluation of SRN was performed in the affected side and compared to the unaffected side. The ratio of cross-sectional area around lesion site was calculated between affected and unaffected sides.
Results: The symptoms were located on the lateral area in 5 patients, the medial area in 10 patients, and in both areas in 8 patients. Electrophysiological study demonstrated abnormal response on the lateral branch in 5 patients, the medial branch in 8 patients, and both branches in 10 patients. Among 10 patients with medial area symptoms, two patients showed abnormal response in both branches. Among 16 patients with positive Tinel sign, ultrasonographic examination localized the lesion site in 14 patients (87.5%). Also, ultrasonographic examination provided nerve morphological changes (nerve or fascicular swelling and nerve continuity) and space occupying lesion (ganglion) in 20 patients (87%).
Conclusions: Ultrasonography is a good diagnostic tool for evaluating the precise lesion location and structural abnormalities in superficial radial sensory neuropathy and can be used as a complementary modality with electrodiagnostic tests for the diagnosis of superficial radial sensory neuropathy.
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Table 1. Patient and Disease Characteristics according to Lesion of Superficial Radial Sensory Neuropathy based on the Electrodiagnostic Study
Table 2. Clinical, Neurophysiologic, and Ultrasonographic Findings of Patients with Superficial Radial Sensory Neuropathy
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