title: US of the Peripheral Nerves of the Upper Extremity: A Landmark Approach.
abstract: Ultrasonography (US) has become a first-line modality for the evaluation of the peripheral nerves of the upper extremity. The benefits of US over magnetic resonance (MR) imaging include higher soft-tissue resolution, cost effectiveness, portability, real-time and dynamic imaging, and the ability to scan an entire extremity quickly and efficiently. US can be performed on patients who are not eligible for MR imaging. Metallic implant artifacts are usually not problematic. US has been shown to have equal specificity and greater sensitivity than MR imaging in the evaluation of peripheral nerves. Any abnormal findings can be easily compared with the contralateral side. The published literature has shown that US has demonstrated clinical utility in patients with suspected peripheral nerve disease by guiding diagnostic and therapeutic decisions as well as by confirming electrodiagnostic findings. Common indications for upper extremity peripheral nerve US are the evaluation for injury due to penetrating trauma, entrapment by scar tissue, and tumor. US of the upper extremity is most commonly performed to evaluate carpal and cubital tunnel syndrome. It is important for the radiologist or sonographer to have a detailed knowledge of anatomy and specific anatomic landmarks for each nerve to efficiently and accurately perform an examination. The goal of this article is to introduce readers to the basics of US of the peripheral nerves of the upper extremity with a focus on the median, ulnar, and radial nerves. Common sites of disease and the location of important anatomic landmarks will be reviewed.
authors.affiliation: From the Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109.
authors.forename: Jordan M
authors.initials: JM
authors.lastname: Brown
authors.affiliation: From the Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109.
authors.forename: Corrie M
authors.initials: CM
authors.lastname: Yablon
authors.affiliation: From the Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Morag
authors.affiliation: From the Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Brandon
authors.affiliation: From the Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109.
authors.forename: Jon A
authors.initials: JA
authors.lastname: Jacobson
mesh_terms: D001132:Arm / Q000000981:diagnostic imaging / Q000294:innervation*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008475:Median Nerve / Q000000981:diagnostic imaging; D059348:Peripheral Nerve Injuries / Q000000981:diagnostic imaging; D010525:Peripheral Nerves / Q000000981:diagnostic imaging*; D010523:Peripheral Nervous System Diseases / Q000000981:diagnostic imaging*; D011826:Radial Nerve / Q000000981:diagnostic imaging; D014459:Ulnar Nerve / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*