Sonographic evaluation of uncommonly assessed upper extremity peripheral nerves: anatomy, technique, and clinical syndromes

Jonathan M. Youngner*, Kulia Matsuo, Tom Grant, Ankur Garg, Jonathan Samet, Imran M. Omar

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

Targeted ultrasound of the median, ulnar, and radial nerves is a well-established technique for suspected upper extremity peripheral neuropathy. However, sonographic imaging of the brachial plexus and smaller peripheral nerve branches is more technically difficult and the anatomy is less familiar to many radiologists. As imaging techniques improve, many clinicians refer patients for imaging of previously less-familiar structures. In addition, some patients may present with injuries that could involve local neurovascular structures. Finally, patients presenting with isolated peripheral neuropathies may be referred for perineural injections with local anesthetic for diagnostic purposes, or steroid for therapeutic reasons. This requires sonologists to have a firm understanding of the courses of these nerves and the surrounding anatomic landmarks that can be used to accurately identify and characterize them. We discuss clinical syndromes referable to specific peripheral nerve branches in the upper extremity, the relevant anatomy, and sonographic technique.

Original languageEnglish (US)
Pages (from-to)57-74
Number of pages18
JournalSkeletal Radiology
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Perineural injection
  • Peripheral nerve
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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