Quantitative ultrasonography in focal neuropathies as compared to clinical and EMG findings.
OBJECTIVE
The aim of this study was to assess the diagnostic value of muscle ultrasonography in focal neuropathies.


METHODS
100 patients suffering from unilateral symptoms or signs on the extremities indicating injuries of nerve roots, plexus, or peripheral nerves were prospectively examined by manual muscle testing (MMT), electromyography (EMG), and quantitative muscle ultrasonography. Muscle thickness and echointensity (gray scale analysis) were measured and compared to the results from 28 control subjects.


RESULTS
Ultrasonography was as sensitive as MMT and EMG in detecting muscle involvement. Ultrasonography and EMG were complementary. In 27% of 85 paretic muscles, only one of both techniques revealed pathological findings. Increased echointensity was seen in 82%, atrophy in 31% of pathological muscles. Earliest ultrasonographic abnormalities and pathological spontaneous activity in EMG appeared 10 days after the injury. The inter-observer agreement of ultrasonography was slightly, but significantly lower than that of EMG.


CONCLUSIONS
Muscle ultrasound can visualize anatomical abnormalities such as muscle atrophy and mesenchymal abnormalities in lesions of nerve roots, plexus, and peripheral nerve lesions.
Bargfrede
M
M
Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.
Schwennicke
A
A
Tumani
H
H
Reimers
C D
CD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001917:Brachial Plexus / Q000293:injuries; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000294:innervation*; D009133:Muscular Atrophy / Q000175:diagnosis / Q000000981:diagnostic imaging; D059348:Peripheral Nerve Injuries; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D013126:Spinal Nerve Roots / Q000293:injuries; D014463:Ultrasonography