title: Ultrasound combined with electrodiagnosis improves lesion localization and outcome in posterior interosseous neuropathy.
abstract: BACKGROUND
  Posterior interosseous nerve (PIN) syndrome is a rare compression neuropathy. Electrodiagnostic studies (EDx) combined with neuromuscular ultrasound (US) enable precise lesion localization and may improve patient outcome.
  
  
  METHODS
  In 4 patients with finger extension weakness, US was used to accurately localize concentric electromyographic (EMG) needle placement in PIN muscles and to visualize the lesion site.
  
  
  RESULTS
  EMG with US guidance showed decreased recruitment with abnormal configuration in PIN muscles. Active denervation was not always observed. US scanning demonstrated larger PIN diameter in the affected arm. All patients had surgical intervention to confirm EDx and US findings and had improved outcome on follow-up.
  
  
  CONCLUSIONS
  These cases demonstrate the benefits of augmenting EDx with US by guiding accurate electrode localization and providing diagnostic information about lesion location.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, 3457 Fifth Avenue, Kaufmann Building, Suite 201, Pittsburgh, Pennsylvania, 15213, USA.
authors.forename: Yevgeniya Dvorkin
authors.initials: YD
authors.lastname: Wininger
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, 3457 Fifth Avenue, Kaufmann Building, Suite 201, Pittsburgh, Pennsylvania, 15213, USA.
authors.forename: Neilly A
authors.initials: NA
authors.lastname: Buckalew
authors.affiliation: Department of Orthopedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kaufmann
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, 3457 Fifth Avenue, Kaufmann Building, Suite 201, Pittsburgh, Pennsylvania, 15213, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Munin
mesh_terms: D000368:Aged; D004576:Electromyography; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler
keywords: electrodiagnosis; outcome surgery; posterior interosseous nerve syndrome; ultrasound