title: High-resolution ultrasonographic evaluation of "hourglass-like fascicular constriction" in peripheral nerves: a preliminary report.
abstract: An hourglass-like constriction is a focal fascicular lesion observed in one or a few places in one or a few fascicles of a peripheral nerve trunk, and usually affects the anterior interosseous (AIN) or posterior interosseous (PIN) nerve. Constrictions have previously been discovered only by surgical exploration, and have been unable to be recognized on pre-operative imaging. We encountered some cases in which the lesion was able to be diagnosed pre-operatively by high-resolution ultrasonography; these findings were then confirmed intra-operatively. Five consecutive cases were included in this study. In three cases with constrictions revealed on pre-operative ultrasound, the findings were confirmed intra-operatively. In the remaining two cases in which no constrictions were detected pre-operatively, no constriction was revealed intra-operatively. High-resolution ultrasonography may play a significant role in the diagnosis of hourglass-like constrictions, and may thus lead to significant changes in treatment strategies for AIN and PIN palsy.
authors.affiliation: Department of Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: Department of Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, Japan. Electronic address: torusuna@hiroshima-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Sunagawa
authors.affiliation: Department of Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Rikuo
authors.initials: R
authors.lastname: Shinomiya
authors.affiliation: Department of Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Mitsu
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging*; D010243:Paralysis / Q000000981:diagnostic imaging*; D010525:Peripheral Nerves / Q000000981:diagnostic imaging*; D010523:Peripheral Nervous System Diseases / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography
keywords: Diagnosis; High-frequency ultrasonography; Hourglass-like constriction; Nerve fascicle; Peripheral nerve palsy