Semin Musculoskelet Radiol 2017; 21(02): 122-136
DOI: 10.1055/s-0037-1599206
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging Nerve Pathology of the Knee: Magnetic Resonance Imaging and Ultrasound

Yoav Morag
1   Division of Musculoskeletal Imaging, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
,
Lynda J.S. Yang
2   Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan
› Author Affiliations
Further Information

Publication History

Publication Date:
29 March 2017 (online)

Abstract

Peripheral neuropathies are not uncommon, and the diagnostic evaluation includes a clinical assessment and electrophysiologic studies as well as diagnostic imaging. Magnetic resonance imaging (MRI) and high-resolution ultrasound (HRUS) are of special importance in providing the surgeon with information in the context of nerve trauma, entrapment, and nerve involvement by tumors. Peripheral neuropathy about the knee can occur in the context of associated knee pathology such as trauma, as part of a systemic disease, or as an isolated finding. In this review, we discuss the role of MRI and HRUS in the evaluation of peripheral neuropathy and present imaging examples of peripheral neuropathy involving the knee.

 
  • References

  • 1 Bianchi S. Ultrasound of the peripheral nerves. Joint Bone Spine 2008; 75 (6) 643-649
  • 2 Immerman I, Price AE, Alfonso I, Grossman JA. Lower extremity nerve trauma. Bull Hosp Jt Dis (2013) 2014; 72 (1) 43-52
  • 3 Chhabra A, Andreisek G. Magnetic Resonance Neurography. New Delhi, India: Jaypee Brothers Medical Publications; 2012
  • 4 Visser LH, Hens V, Soethout M, De Deugd-Maria V, Pijnenburg J, Brekelmans GJ. Diagnostic value of high-resolution sonography in common fibular neuropathy at the fibular head. Muscle Nerve 2013; 48 (2) 171-178
  • 5 Plastaras CT, Chhatre A, Kotcharian AS. Perioperative lower extremity peripheral nerve traction injuries. Orthop Clin North Am 2014; 45 (1) 55-63
  • 6 Krivić A, Stanec S, Zic R, Budi S, Milanović R, Stanec Z. Lesion of the common peroneal nerve during arthroscopy. Arthroscopy 2003; 19 (9) 1015-1018
  • 7 Tagliafico A, Altafini L, Garello I, Marchetti A, Gennaro S, Martinoli C. Traumatic neuropathies: spectrum of imaging findings and postoperative assessment. Semin Musculoskelet Radiol 2010; 14 (5) 512-522
  • 8 Van den Bergh FR, Vanhoenacker FM, De Smet E, Huysse W, Verstraete KL. Peroneal nerve: normal anatomy and pathologic findings on routine MRI of the knee. Insights Imaging 2013; 4 (3) 287-299
  • 9 Walker FO, Cartwright MS, Wiesler ER, Caress J. Ultrasound of nerve and muscle. Clin Neurophysiol 2004; 115 (3) 495-507
  • 10 Seddon HJ. A classification of nerve injuries. BMJ 1942; 2 (4260): 237-239
  • 11 Sunderland S, Bradley KC. The cross-sectional area of peripheral nerve trunks devoted to nerve fibers. Brain 1949; 72 (3) 428-449
  • 12 Giuseffi SA, Bishop AT, Shin AY, Dahm DL, Stuart MJ, Levy BA. Surgical treatment of peroneal nerve palsy after knee dislocation. Knee Surg Sports Traumatol Arthrosc 2010; 18 (11) 1583-1586
  • 13 Padua L, Di Pasquale A, Liotta G , et al. Ultrasound as a useful tool in the diagnosis and management of traumatic nerve lesions. Clin Neurophysiol 2013; 124 (6) 1237-1243
  • 14 Kim DH, Cho YJ, Tiel RL, Kline DG. Outcomes of surgery in 1019 brachial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg 2003; 98 (5) 1005-1016
  • 15 Capek S, Hébert-Blouin MN, Puffer RC , et al. Tumefactive appearance of peripheral nerve involvement in hematologic malignancies: a new imaging association. Skeletal Radiol 2015; 44 (7) 1001-1009
  • 16 Grisold W, Briani C, Vass A. Malignant cell infiltration in the peripheral nervous system. Handb Clin Neurol 2013; 115: 685-712
  • 17 Ghosh PS, Shah SN, Mitra S. Knee MRI showing thickened peripheral nerves in Charcot-Marie-Tooth disease. Acta Neurol Belg 2012; 112 (3) 315-316
  • 18 Chhabra A, Faridian-Aragh N, Chalian M , et al. High-resolution 3-T MR neurography of peroneal neuropathy. Skeletal Radiol 2012; 41 (3) 257-271
  • 19 Damarey B, Demondion X, Wavreille G, Pansini V, Balbi V, Cotten A. Imaging of the nerves of the knee region. Eur J Radiol 2013; 82 (1) 27-37
  • 20 Spinner RJ, Atkinson JL, Scheithauer BW , et al. Peroneal intraneural ganglia: the importance of the articular branch. Clinical series. J Neurosurg 2003; 99 (2) 319-329
  • 21 Vieira RL, Rosenberg ZS, Kiprovski K. MRI of the distal biceps femoris muscle: normal anatomy, variants, and association with common peroneal entrapment neuropathy. AJR Am J Roentgenol 2007; 189 (3) 549-555
  • 22 Thompson AT, Gallacher PD, Rees R. Lateral meniscal cyst causing irreversible peroneal nerve palsy. J Foot Ankle Surg 2013; 52 (4) 505-507
  • 23 Meylaerts L, Cardinaels E, Vandevenne J , et al. Peroneal neuropathy after weight loss: a high-resolution ultrasonographic characterization of the common peroneal nerve. Skeletal Radiol 2011; 40 (12) 1557-1562
  • 24 Patel A, Singh R, Johnson B, Smith A. Compression neuropathy of the common peroneal nerve by the fabella. BMJ Case Rep 2013; 2013: bcr2013202154
  • 25 Cesmebasi A, Howe BM, Amrami KK, Spinner RJ. Sequential MR imaging demonstrates evolution of a fibular intraneural ganglion cyst after knee dislocation. Clin Anat 2015; 28 (1) 2-4
  • 26 Spinner RJ, Amrami KK, Angius D, Wang H, Carmichael SW. Peroneal and tibial intraneural ganglia: correlation between intraepineurial compartments observed on magnetic resonance images and the potential importance of these compartments. Neurosurg Focus 2007; 22 (6) E17
  • 27 Spinner RJ, Puffer RC, Skinner JA, Amrami KK. The MRI appearance and importance of the “very” terminal branches of the recurrent articular branch in fibular intraneural ganglion cysts. Clin Anat 2011; 24 (2) 268-272
  • 28 Prasad NK, Desy NM, Howe BM, Amrami KK, Spinner RJ. Subparaneurial ganglion cysts of the fibular and tibial nerves: a new variant of intraneural ganglion cysts. Clin Anat 2016; 29 (4) 530-537
  • 29 Shahid KR, Hébert-Blouin MN, Amrami KK, Spinner RJ. Extraneural rupture of intraneural ganglion cysts. J Surg Orthop Adv 2011; 20 (2) 136-141
  • 30 Lipinski LJ, Rock MG, Spinner RJ. Peroneal intraneural ganglion cysts at the fibular neck: the layered “U” surgical approach to the articular branch and superior tibiofibular joint. Acta Neurochir (Wien) 2015; 157 (5) 837-840
  • 31 Reddy CG, Amrami KK, Howe BM, Spinner RJ. Combined common peroneal and tibial nerve injury after knee dislocation: one injury or two? An MRI-clinical correlation. Neurosurg Focus 2015; 39 (3) E8
  • 32 Anderson AW, LaPrade RF. Common peroneal nerve neuropraxia after arthroscopic inside-out lateral meniscus repair. J Knee Surg 2009; 22 (1) 27-29
  • 33 Grant JA, Wilde J, Miller BS, Bedi A. Comparison of inside-out and all-inside techniques for the repair of isolated meniscal tears: a systematic review. Am J Sports Med 2012; 40 (2) 459-468
  • 34 Olivecrona C, Blomfeldt R, Ponzer S, Stanford BR, Nilsson BY. Tourniquet cuff pressure and nerve injury in knee arthroplasty in a bloodless field: a neurophysiological study. Acta Orthop 2013; 84 (2) 159-164
  • 35 Ward JP, Yang LJ, Urquhart AG. Surgical decompression improves symptoms of late peroneal nerve dysfunction after TKA. Orthopedics 2013; 36 (4) e515-e519
  • 36 Kedlaya D. Charcot-Marie-Tooth disease. Medscape, WedMD. Available at: http://emedicine.medscape.com/article/1232386-overview#a4 . Accessed November 11, 2016
  • 37 Yiu EM, Brockley CR, Lee KJ , et al. Peripheral nerve ultrasound in pediatric Charcot-Marie-Tooth disease type 1A. Neurology 2015; 84 (6) 569-574
  • 38 Hines AE, Birn H, Teglbjaerg PS, Sinkjaer T. Fiber type composition of articular branches of the tibial nerve at the knee joint in man. Anat Rec 1996; 246 (4) 573-578
  • 39 Ladak A, Spinner RJ, Amrami KK, Howe BM. MRI findings in patients with tibial nerve compression near the knee. Skeletal Radiol 2013; 42 (4) 553-559
  • 40 Mastaglia FL. Tibial nerve entrapment in the popliteal fossa. Muscle Nerve 2000; 23 (12) 1883-1886
  • 41 Williams EH, Williams CG, Rosson GD, Dellon AL. Combined peroneal and proximal tibial nerve palsies. Microsurgery 2009; 29 (4) 259-264
  • 42 Spinner RJ, Hébert-Blouin MN, Amrami KK, Rock MG. Peroneal and tibial intraneural ganglion cysts in the knee region: a technical note. Neurosurgery 2010; 67 (3, Suppl Operative) ons71-ons78 ; discussion ons78
  • 43 Pai VS. Traumatic aneurysm of the perforating peroneal artery following ankle fracture. J Foot Ankle Surg 1999; 38 (6) 417-419
  • 44 Moyad TF. Massive Baker cyst resulting in tibial nerve compression neuropathy secondary to polyethylene wear disease. Am J Orthop 2015; 44 (4) E113-E116
  • 45 Ji JH, Shafi M, Kim WY, Park SH, Cheon JO. Compressive neuropathy of the tibial nerve and peroneal nerve by a Baker's cyst: case report. Knee 2007; 14 (3) 249-252
  • 46 Baena AE, Castilla BM, Fernandez JS, de Rota Conde AF, Reina AE, Rubio FE. Inside-out medial meniscus suture: an analysis of the risk of injury to the popliteal neurovascular bundle. Arthroscopy 2011; 27 (4) 516-521
  • 47 Kim DH, Murovic JA, Tiel RL, Kline DG. Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center. Neurosurgery 2004; 54 (6) 1421-1428 ; discussion 1428–1429
  • 48 Cho D, Saetia K, Lee S, Kline DG, Kim DH. Peroneal nerve injury associated with sports-related knee injury. Neurosurg Focus 2011; 31 (5) E11
  • 49 Bertram C, Porsch M, Hackenbroch MH, Terhaag D. Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft. Arthroscopy 2000; 16 (7) 763-766
  • 50 Porr J, Chrobak K, Muir B. Entrapment of the saphenous nerve at the adductor canal affecting the infrapatellar branch—a report on two cases. J Can Chiropr Assoc 2013; 57 (4) 341-349
  • 51 Beltran LS, Bencardino J, Ghazikhanian V, Beltran J. Entrapment neuropathies III: lower limb. Semin Musculoskelet Radiol 2010; 14 (5) 501-511
  • 52 Sole JS, Pingree MJ, Spinner RJ, Murthy NS, Sellon JL. Saphenous neuropathy secondary to extraneural ganglion cyst 15 years after reconstruction of the anterior cruciate ligament. PM R 2014; 6 (5) 451-455
  • 53 Widmer F, Gerster JC. Medial meniscal cyst imitating a tumor, with compression of the saphenous nerve. Rev Rhum Engl Ed 1998; 65 (2) 149-152
  • 54 Morganti CM, McFarland EG, Cosgarea AJ. Saphenous neuritis: a poorly understood cause of medial knee pain. J Am Acad Orthop Surg 2002; 10 (2) 130-137
  • 55 Jose J, Smith MK, Kaplan LD, Lesniak BP, Levi AD. Ultrasound-guided needle localization of the saphenous nerve for removal of neuroma in the infrapatellar branches: technical report. Neurosurgery 2014; 75 (6) 717-722 ; discussion 722
  • 56 Clendenen S, Greengrass R, Whalen J, O'Connor MI. Infrapatellar saphenous neuralgia after TKA can be improved with ultrasound-guided local treatments. Clin Orthop Relat Res 2015; 473 (1) 119-125
  • 57 Horn JL, Pitsch T, Salinas F, Benninger B. Anatomic basis to the ultrasound-guided approach for saphenous nerve blockade. Reg Anesth Pain Med 2009; 34 (5) 486-489