title: Muscle ultrasonography: a diagnostic tool for amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  In a prospective study we tested whether muscle ultrasonography can differentiate between amyotrophic lateral sclerosis (ALS) and mimics. Furthermore, we assessed the ability of ultrasonography to identify subclinical lower motor neuron involvement.
  
  
  METHODS
  In 59 patients, suspected for adult onset motor neuron disease, ultrasound scans were made of 12 different muscle groups. Echo intensity was determined and each muscle was screened for fasciculations. Ultrasonography was considered diagnostic for ALS when echo intensity was 1.5 SD above normal in at least two muscles and fasciculations were present in at least four muscles.
  
  
  RESULTS
  Ultrasonography differentiated between ALS and mimics with 96% sensitivity and 84% specificity. In the 27 ALS patients, ultrasonography detected 15 regions with lower motor neuron involvement that were negative using either clinical examination or needle EMG.
  
  
  CONCLUSIONS
  Muscle ultrasound can differentiate between amyotrophic lateral sclerosis and mimics with high sensitivity and specificity, and is a sensitive tool to screen for regional lower motor neuron involvement.
  
  
  CONCLUSIONS
  Muscle ultrasonography is a promising tool in the diagnostic work up of ALS.
authors.affiliation: Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Ilse M P
authors.initials: IM
authors.lastname: Arts
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Overeem
authors.forename: Sigrid
authors.initials: S
authors.lastname: Pillen
authors.forename: Bert U
authors.initials: BU
authors.lastname: Kleine
authors.forename: Werner A
authors.initials: WA
authors.lastname: Boekestein
authors.forename: Machiel J
authors.initials: MJ
authors.lastname: Zwarts
authors.forename: H
authors.initials: H
authors.lastname: Jurgen Schelhaas
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004576:Electromyography; D005207:Fasciculation / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D009046:Motor Neurons / Q000502:physiology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D009460:Neurologic Examination; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014463:Ultrasonography