Diagnostic sensitivity of electrophysiology and ultrasonography in ulnar neuropathies of different severity |
| |
| Affiliation: | 1. Department of Neurology and Clinical Neurophysiology, Bay of Plenty District Health Board, Tauranga Hospital, Tauranga, New Zealand;2. Department of Neurology and Clinical Neurophysiology, Auckland District Health Board, Auckland Hospital, Auckland, New Zealand;1. Division of Neurosurgery, University of Messina, A.O.U. Policlinico “G. Martino”, Messina, Italy;2. Department of Clinical and Experimental Medicine, University of Messina, A.O.U. Policlinico “G. Martino”, Messina, Italy;3. Anesthesiology and Intensive Care Unit, University of Messina, A.O.U. Policlinico “G. Martino”, Messina, Italy;4. Division of Neurology, University of Messina, A.O.U. Policlinico “G. Martino”, Messina, Italy;5. Division of Radiological Sciences, University of Messina, A.O.U. Policlinico “G. Martino”, Messina, Italy;6. Division of Neurosurgery, Department of Medical and Surgical Sciences, University of Catanzaro, Messina, Italy;1. Division of Neurology, University of Toronto, Toronto, Ontario, Canada;2. Division of Neurology, Ichilov Hospital, Tel Aviv University, Tel Aviv, Israel;3. Prosserman Family Neuromuscular Clinic, University Health Network, Toronto, Ontario, Canada;4. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada;5. Division of Neurology, Department of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Japan;2. Department of Orthopaedic Surgery, Shinshu University School of Medicine, Japan;3. Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan;4. Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, Japan;5. Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan;6. Department of Orthopaedic Surgery, Chiba University School of Medicine, Japan;7. Department of Orthopaedic Surgery, Sapporo City General Hospital, Japan;1. Neurophysiology Unit, Iatropolis Medical Group, Athens, Halandri 15231, Greece;2. Second Department of Neurology, “Attikon” Hospital, School of Medicine, National and Kapodistrian University of Athens, Chaidari 12462, Athens, Greece;3. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA;4. First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;5. Department of Neurology, Gennimatas General Hospital, Athens, Greece;6. Department of Neurology, School of Medicine, University of Patras, Greece |
| |
| Abstract: | ObjectiveTo assess the diagnostic performance of electrophysiology and nerve ultrasound in ulnar neuropathies of varying clinical severity in 135 consecutive patients.MethodsClinical severity of ulnar neuropathy was graded on a 4 point scale from very mild (symptoms only) to severe (marked atrophy of intrinsic hand muscles). Sensitivity and localization ability of electrophysiology and nerve ultrasound were assessed for each point of the scale.ResultsUltrasound had higher sensitivity than electrophysiology in clinically very mild (20% and 3% for ultrasound and electrophysiology, respectively) and mild (62% and 47% for ultrasound and electrophysiology, respectively) neuropathies, had greater localizing ability in axonal ulnar neuropathies, and identified nerve hypermobility.Ultrasound nerve cross-sectional area had strong positive correlation with both clinical and electrophysiological severity scores, but with significant overlap across the severity groups.ConclusionThe diagnostic work-up of ulnar neuropathies was improved by using both electrophysiology and ultrasound at all levels of clinical severity. Ultrasound increased the diagnostic yield in very mild and mild neuropathies, localized all the ulnar neuropathies with abnormal non-localizing electrophysiology and identified nerve hypermobility.SignificanceThis is the first detailed analysis of the diagnostic performance of electrophysiology and ultrasound in ulnar neuropathies of varying severity. |
| |
| Keywords: | Ulnar nerve ultrasound Electrophysiology Cross-sectional area Clinical severity ADM" },{" #name" :" keyword" ," $" :{" id" :" k0030" }," $$" :[{" #name" :" text" ," _" :" Abductor Digiti Minimi CMAP" },{" #name" :" keyword" ," $" :{" id" :" k0040" }," $$" :[{" #name" :" text" ," _" :" Compound Muscle Action Potential CSA" },{" #name" :" keyword" ," $" :{" id" :" k0050" }," $$" :[{" #name" :" text" ," _" :" Cross Sectional Area CSA Max" },{" #name" :" keyword" ," $" :{" id" :" k0060" }," $$" :[{" #name" :" text" ," _" :" Maximal Cross Sectional Area EDX" },{" #name" :" keyword" ," $" :{" id" :" k0070" }," $$" :[{" #name" :" text" ," _" :" Electrophysiology EMG" },{" #name" :" keyword" ," $" :{" id" :" k0080" }," $$" :[{" #name" :" text" ," _" :" Electromyography FDI" },{" #name" :" keyword" ," $" :{" id" :" k0090" }," $$" :[{" #name" :" text" ," _" :" First Dorsal Interosseous MRC" },{" #name" :" keyword" ," $" :{" id" :" k0100" }," $$" :[{" #name" :" text" ," _" :" Medical Research Council SNAP" },{" #name" :" keyword" ," $" :{" id" :" k0110" }," $$" :[{" #name" :" text" ," _" :" Sensory Nerve Action Potential UNE" },{" #name" :" keyword" ," $" :{" id" :" k0120" }," $$" :[{" #name" :" text" ," _" :" Ulnar neuropathy at the elbow |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
