High‐resolution ultrasound in combat‐related peripheral nerve injuries

Smith, Jonathan K.; Miller, Matthew E.; Carroll, Craig G.; Faillace, Walter J.; Nesti, Leon J.; Cawley, Christina; Landau, Mark E.

doi:10.1002/mus.25216

Cited by 16 publications

(14 citation statements)

References 10 publications

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“…In their study, ultrasound was superior to electrodiagnostic test in the ability to clearly demonstrate the specific site of focal nerve involvement among four adults post gunshot or blasts injuries with non-excitable nerve responses; the location was later confirmed by surgical inspection. 119…”

Section: Traumatic Nerve Injuriesmentioning

confidence: 99%

“…– 117 Pillen et al 118 recently showed that the cervical roots, brachial plexus, and proximal nerves can be visualized by ultrasound as early as the neonatal period, and reference data are available from their standardized nerve ultrasound protocol. As well, Smith et al 119 reported on the utility of ultrasound for patients with combat-related peripheral nerve injuries, in addition to standard clinical, EMG, and MRI exams. In their study, ultrasound was superior to electrodiagnostic test in the ability to clearly demonstrate the specific site of focal nerve involvement among four adults post gunshot or blasts injuries with non-excitable nerve responses; the location was later confirmed by surgical inspection 119 …”

Section: Practical Uses Of Nerve Ultrasoundmentioning

confidence: 99%

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Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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Advances in high-resolution ultrasound have provided clinicians with unique opportunities to study diseases of the peripheral nervous system. Ultrasound complements the clinical and electrophysiology exam by showing the degree of abnormalities in myopathies, as well as spontaneous muscle activities in motor neuron diseases and other disorders. In experienced hands, ultrasound is more sensitive than MRI in detecting peripheral nerve pathologies. It can also guide needle placement for electromyography exam, therapeutic injections, and muscle biopsy. Ultrasound enhances the ability to detect carpal tunnel syndrome and other focal nerve entrapment, as well as pathological nerve enlargements in genetic and acquired neuropathies. Furthermore, ultrasound can potentially be used as a biomarker for muscular dystrophy and spinal muscular atrophy. The combination of electromyography and ultrasound can increase the diagnostic certainty of amyotrophic lateral sclerosis, aid in the localization of brachial plexus or peripheral nerve trauma and allow for surveillance of nerve tumor progression in neurofibromatosis. Potential limitations of ultrasound include an inability to image deeper structures, with lower sensitivities in detecting neuromuscular diseases in young children and those with mitochondrial myopathies, due to subtle changes or early phase of the disease. As well, its utility in detecting critical illness neuromyopathy remains unclear. This review will focus on the clinical applications of neuromuscular ultrasound. The diagnostic values of ultrasound for screening of myopathies, neuropathies, and motor neuron diseases will be presented.

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Section: Traumatic Nerve Injuriesmentioning

confidence: 99%

Section: Practical Uses Of Nerve Ultrasoundmentioning

confidence: 99%

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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“…B-mode ultrasound provides the advantages of being convenient, rapid, non-invasive, and easily portable. Bedside examination is possible when using ultrasound, which reduces further injury of the patient due to movements [ 25 – 27 ]. The United States military also provides B-mode ultrasound to assist with the diagnosis of tension pneumothorax during battlefield emergency rescue.…”

Section: Injury Assessment and Diagnosis For Early Treatment Institutmentioning

confidence: 99%

Expert consensus on the evaluation and diagnosis of combat injuries of the Chinese People’s Liberation Army

et al. 2018

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The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army (PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia (MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level II facilities. In level III facilities, combined measures, including a history inquiry, thorough physical examination, laboratory examination, X-ray, and ultrasound examination, were recommended for the diagnosis of combat casualties. In addition, corresponding methods were recommended for the recognition of casualties needing massive transfusions, assessment of firearm wounds, evaluation of mangled extremities, and assessment of injury severity in this consensus.

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“…[8][9][10] It can sometimes make a diagnosis when EMG is not tolerated or non-informative-for example, by helping to localize pathology when all responses are absent. 11,12 This review will focus on the technical and practical aspects of ultrasound as an imaging technique for muscles and nerves. It can be used as a "how-to" guide to get started with neuromuscular ultrasound in daily practice, to implement a diagnostic tool that adult and pediatric neurologists, clinical neurophysiologists and other specialists can use for patient-friendly, point-of-care imaging.…”

mentioning

confidence: 99%

Neuromuscular Ultrasound: A New Tool in Your Toolbox

Alfen

Mah

2018

Can. J. Neurol. Sci.

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Neuromuscular ultrasound is a rapidly evolving technique for diagnosing, monitoring and facilitating treatment of patients with muscle and nerve disorders. It is a portable point-of-care technology that is non-invasive, painless and without ionizing radiation. Ultrasound can visualize muscle texture alterations indicating dystrophy or denervation, changes in size and anatomic continuity of nerve fascicles, and its dynamic imaging capabilities allow capturing of contractions and fasciculations. Ultrasound can also provide real-time guidance for needle placement, and can sometimes make a diagnosis when electromyography is not tolerated or not informative anymore. This review will focus on the technical and practical aspects of ultrasound as an imaging technique for muscles and nerves. It will discuss basic imaging principles, hardware and software setup, and provide examples of ultrasound use for visualizing muscle and nerve abnormalities with accuracy and confidence. The review is intended as a practical “how-to” guide to get started with neuromuscular ultrasound in daily practice.

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High‐resolution ultrasound in combat‐related peripheral nerve injuries

Abstract: High resolution peripheral nerve US is a useful modality in assessment of combat-related PNI. Muscle Nerve, 2016 Muscle Nerve 54: 1139-1144, 2016.

Cited by 16 publications

References 10 publications

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Expert consensus on the evaluation and diagnosis of combat injuries of the Chinese People’s Liberation Army

Neuromuscular Ultrasound: A New Tool in Your Toolbox

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