Semin Neurol 2019; 39(05): 542-548
DOI: 10.1055/s-0039-1688987
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neuromuscular Ultrasound for Peripheral Neuropathies

Vanessa Baute Penry
1   Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
,
Michael S. Cartwright
1   Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
› Author Affiliations
Further Information

Publication History

Publication Date:
22 October 2019 (online)

Abstract

Neuromuscular ultrasound (NMUS) is a diagnostic technique that is now commonly used to complement electrodiagnostic studies when evaluating for suspected peripheral nerve pathology. The use of NMUS has been described in focal mononeuropathies, polyneuropathies, and motor neuron disease. This article provides a general overview of NMUS for the evaluation of peripheral neuropathies based on clinical practice guidelines, primary literature, and expert opinion. The characteristic changes detected by NMUS are described in focal mononeuropathies (including entrapment and other causes), polyneuropathies (including demyelinating and axonal processes), and motor neuron disease.

Financial Disclosure

Dr. Baute Penry has nothing to disclose. Dr. Cartwright receives royalties from Elsevier for the textbook Neuromuscular Ultrasound.


Author contribution

Dr. Vanessa Baute Penry and Dr. Michael Cartwright participated in study concept and design, acquisition of data, and critical revision of the manuscript for important intellectual content.


 
  • References

  • 1 Fornage BD. Peripheral nerves of the extremities: imaging with US. Radiology 1988; 167 (01) 179-182
  • 2 Buchberger W, Schön G, Strasser K, Jungwirth W. High-resolution ultrasonography of the carpal tunnel. J Ultrasound Med 1991; 10 (10) 531-537
  • 3 Walker FO, Cartwright MS, Alter KC. , et al. Indications for neuromuscular ultrasound: expert opinion and review of the literature. Clin Neurophysiol 2018; 129 (12) 2658-2679
  • 4 Zaidman CM, Seelig MJ, Baker JC, Mackinnon SE, Pestronk A. Detection of peripheral nerve pathology: comparison of ultrasound and MRI. Neurology 2013; 80 (18) 1634-1640
  • 5 Walker FO, Cartwright M. Neuromuscular Ultrasound. 1st ed. Philadelphia, PA: Elsevier; 2012
  • 6 Strakowski J. Ultrasound Evaluation of Focal Neuropathies: Correlation with Electrodiagnosis. 1st ed. New York, NY: Demos Medical; 2013
  • 7 Walker FO, Alter KE, Boon AJ. , et al. Qualifications for practitioners of neuromuscular ultrasound: position statement of the American Association of Neuromuscular and Electrodiagnostic Medicine. Muscle Nerve 2010; 42 (03) 442-444
  • 8 Cartwright MS, Walker FO. Neuromuscular ultrasound in common entrapment neuropathies. Muscle Nerve 2013; 48 (05) 696-704
  • 9 Cartwright MS, Walker FO, Griffin LP, Caress JB. Peripheral nerve and muscle ultrasound in amyotrophic lateral sclerosis. Muscle Nerve 2011; 44 (03) 346-351
  • 10 Cartwright MS, Demar S, Griffin LP, Balakrishnan N, Harris JM, Walker FO. Validity and reliability of nerve and muscle ultrasound. Muscle Nerve 2013; 47 (04) 515-521
  • 11 Cartwright MS, Hobson-Webb LD, Boon AJ. , et al; American Association of Neuromuscular and Electrodiagnostic Medicine. Evidence-based guideline: neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome. Muscle Nerve 2012; 46 (02) 287-293
  • 12 Cartwright MS, Griffin LP, Dowlen H. , et al. A randomized trial of diagnostic ultrasound to improve outcomes in focal neuropathies. Muscle Nerve 2015; 52 (05) 746-753
  • 13 Telleman JA, Grimm A, Goedee S, Visser LH, Zaidman CM. Nerve ultrasound in polyneuropathies. Muscle Nerve 2018; 57 (05) 716-728
  • 14 Wiesler ER, Chloros GD, Cartwright MS, Smith BP, Rushing J, Walker FO. The use of diagnostic ultrasound in carpal tunnel syndrome. J Hand Surg Am 2006; 31 (05) 726-732
  • 15 Cartwright MS, White DL, Demar S. , et al. Median nerve changes following steroid injection for carpal tunnel syndrome. Muscle Nerve 2011; 44 (01) 25-29
  • 16 Walker FO, Cartwright MS, Blocker JN. , et al. Prevalence of bifid median nerves and persistent median arteries and their association with carpal tunnel syndrome in a sample of Latino poultry processors and other manual workers. Muscle Nerve 2013; 48 (04) 539-544
  • 17 Cartwright MS, Walker FO, Newman JC. , et al. Muscle intrusion as a potential cause of carpal tunnel syndrome. Muscle Nerve 2014; 50 (04) 517-522
  • 18 Martin MJ, Cartwright MS. A pilot study of strain elastography in the diagnosis of carpal tunnel syndrome. J Clin Neurophysiol 2017; 34 (02) 114-118
  • 19 Wiesler ER, Chloros GD, Cartwright MS, Shin HW, Walker FO. Ultrasound in the diagnosis of ulnar neuropathy at the cubital tunnel. J Hand Surg Am 2006; 31 (07) 1088-1093
  • 20 Van Den Berg PJ, Pompe SM, Beekman R, Visser LH. Sonographic incidence of ulnar nerve (sub)luxation and its associated clinical and electrodiagnostic characteristics. Muscle Nerve 2013; 47 (06) 849-855
  • 21 Visser LH. High-resolution sonography of the common peroneal nerve: detection of intraneural ganglia. Neurology 2006; 67 (08) 1473-1475
  • 22 Wilson TJ, Hébert-Blouin M-N, Murthy NS, Amrami KK, Spinner RJ. Recognition of peroneal intraneural ganglia in an historical cohort with “negative” MRIs. Acta Neurochir (Wien) 2017; 159 (05) 925-930
  • 23 Cartwright MS, Chloros GD, Walker FO, Wiesler ER, Campbell WW. Diagnostic ultrasound for nerve transection. Muscle Nerve 2007; 35 (06) 796-799
  • 24 Martinoli C, Bianchi S, Derchi LE. Ultrasonography of peripheral nerves. Semin Ultrasound CT MR 2000; 21 (03) 205-213
  • 25 Sneag DB, Rancy SK, Wolfe SW. , et al. Brachial plexitis or neuritis? MRI features of lesion distribution in Parsonage-Turner syndrome. Muscle Nerve 2018; 58 (03) 359-366
  • 26 ArÁnyi Z, Csillik A, DéVay K. , et al. Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations. Muscle Nerve 2017; 56 (06) 1054-1062
  • 27 Zaidman CM, Al-Lozi M, Pestronk A. Peripheral nerve size in normals and patients with polyneuropathy: an ultrasound study. Muscle Nerve 2009; 40 (06) 960-966
  • 28 Hobson-Webb LD, Cartwright MS. Nerve ultrasound in CIDP: poly-parameters for polyneuropathies. Clin Neurophysiol 2014; 125 (01) 3-4
  • 29 Kerasnoudis A, Pitarokoili K, Gold R, Yoon M-S. Nerve ultrasound and electrophysiology for therapy monitoring in chronic inflammatory demyelinating polyneuropathy. J Neuroimaging 2015; 25 (06) 931-939
  • 30 Härtig F, Ross M, Dammeier NM. , et al. Nerve ultrasound predicts treatment response in chronic inflammatory demyelinating polyradiculoneuropathy-a prospective follow-up. Neurotherapeutics 2018; 15 (02) 439-451
  • 31 Zaidman CM, Harms MB, Pestronk A. Ultrasound of inherited vs. acquired demyelinating polyneuropathies. J Neurol 2013; 260 (12) 3115-3121
  • 32 Jongbloed BA, Haakma W, Goedee HS. , et al. Comparative study of peripheral nerve Mri and ultrasound in multifocal motor neuropathy and amyotrophic lateral sclerosis. Muscle Nerve 2016; 54 (06) 1133-1135
  • 33 Cartwright MS, Brown ME, Eulitt P, Walker FO, Lawson VH, Caress JB. Diagnostic nerve ultrasound in Charcot-Marie-Tooth disease type 1B. Muscle Nerve 2009; 40 (01) 98-102
  • 34 Borire AA, Issar T, Kwai NC. , et al. Correlation between markers of peripheral nerve function and structure in type 1 diabetes. Diabetes Metab Res Rev 2018; 34 (07) e3028
  • 35 Üçeyler N, Schäfer KA, Mackenrodt D, Sommer C, Müllges W. High-resolution ultrasonography of the superficial peroneal motor and sural sensory nerves may be a non-invasive approach to the diagnosis of vasculitic neuropathy. Front Neurol 2016; 7: 48
  • 36 Pelosi L, Mulroy E, Leadbetter R. , et al. Peripheral nerves are pathologically small in cerebellar ataxia neuropathy vestibular areflexia syndrome: a controlled ultrasound study. Eur J Neurol 2018; 25 (04) 659-665
  • 37 Heckmatt JZ, Leeman S, Dubowitz V. Ultrasound imaging in the diagnosis of muscle disease. J Pediatr 1982; 101 (05) 656-660
  • 38 Arts IMP, Overeem S, Pillen S, Jurgen Schelhaas H, Zwarts MJ. Muscle changes in amyotrophic lateral sclerosis: a longitudinal ultrasonography study. Clin Neurophysiol 2011; 122 (03) 623-628
  • 39 Misawa S, Noto Y, Shibuya K. , et al. Ultrasonographic detection of fasciculations markedly increases diagnostic sensitivity of ALS. Neurology 2011; 77 (16) 1532-1537
  • 40 Caress JB, Cartwright MS. Neuromuscular ultrasound as a biomarker in amyotrophic lateral sclerosis. Muscle Nerve 2018; 58 (06) 747-748
  • 41 Padua L, Aprile I, Pazzaglia C. , et al. Contribution of ultrasound in a neurophysiological lab in diagnosing nerve impairment: a one-year systematic assessment. Clin Neurophysiol 2007; 118 (06) 1410-1416
  • 42 Baute V, Strakowski JA, Reynolds JW. , et al. Neuromuscular ultrasound of the brachial plexus: a standardized approach. Muscle Nerve 2018; 58 (05) 618-624