Nerve Entrapment Syndromes at the Wrist and Elbow by Sonography

Klauser, Andrea; Buzzegoli, Tommaso; Taljanovic, Mihra S.; Strobl, Sylvia; Rauch, Stefan; Teh, James; Wanschitz, Julia; Löscher, Wolfgang N.; Martinoli, Carlo

doi:10.1055/s-0038-1641577

Cited by 24 publications

(31 citation statements)

References 37 publications

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“…Compression neuropathy [46][47][48] Disorder characterised by nerve dysfunction as a result of nerve entrapment or extrinsic impingement Hypoechoic appearance of nerve from epineural oedema with possible fascicular enlargement typically proximal and sometimes distal to the compression site (figure 6A)…”

Section: (E) Nervementioning

confidence: 99%

Recommended musculoskeletal and sports ultrasound terminology: a Delphi-based consensus statement

et al. 2022

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The current lack of agreement regarding standardised terminology in musculoskeletal and sports ultrasound presents challenges in education, clinical practice and research. This consensus was developed to provide a reference to improve clarity and consistency in communication. A multidisciplinary expert panel was convened consisting of 18 members representing multiple specialty societies identified as key stakeholders in musculoskeletal and sports ultrasound. A Delphi process was used to reach consensus, which was defined as group level agreement of >80%. Content was organised into seven general topics including: (1) general definitions, (2) equipment and transducer manipulation, (3) anatomical and descriptive terminology, (4) pathology, (5) procedural terminology, (6) image labelling and (7) documentation. Terms and definitions which reached consensus agreement are presented herein. The historic use of multiple similar terms in the absence of precise definitions has led to confusion when conveying information between colleagues, patients and third-party payers. This multidisciplinary expert consensus addresses multiple areas of variability in diagnostic ultrasound imaging and ultrasound-guided procedures related to musculoskeletal and sports medicine.

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Section: (E) Nervementioning

confidence: 99%

Recommended musculoskeletal and sports ultrasound terminology: a Delphi-based consensus statement

et al. 2022

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“…The nerve is compressed at the level of the cubital tunnel, a fibro-osseous tunnel formed by the olecranon process laterally, medial epicondyle medially, elbow joint capsule anteriorly, and Osborne’s retinaculum posteriorly. The shape of the cubital tunnel changes with elbow flexion and external factors, resulting in chronic pressure and consequent tunnel narrowing ( 14 ) . The typical symptoms are pain, weakness and paresthesia in the fourth and fifth fingers, as well as numbness of the dorsal ulnar side of the hand ( 14 ) .…”

Section: Elbowmentioning

confidence: 99%

“…The shape of the cubital tunnel changes with elbow flexion and external factors, resulting in chronic pressure and consequent tunnel narrowing ( 14 ) . The typical symptoms are pain, weakness and paresthesia in the fourth and fifth fingers, as well as numbness of the dorsal ulnar side of the hand ( 14 ) .…”

Section: Elbowmentioning

confidence: 99%

Ultrasound-guided musculoskeletal interventional procedures around the elbow, hand and wrist excluding carpal tunnel procedures

et al. 2021

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Ultrasound is a fast, reliable and radiation-free method for the assessment of a wide range of pathological conditions, as well as for the guidance of percutaneous interventional procedures around the elbow, hand and wrist. Intraarticular and periarticular interventional procedures can be easily performed under continuous ultrasound monitoring to ensure correct needle positioning and medication delivery to a specific target. The most common ultrasound-guided procedures performed around the elbow, wrist, and hand are described in this review, excluding carpal tunnel procedures. Specifically, elbow steroid injections are performed in patients with inflammatory disorders, while hyaluronic acid can be administered in case of osteoarthritis. Septic olecranon bursitis requires percutaneous drainage for diagnosis and appropriate treatment. Dry needling and injection of regenerative medications, such as blood derivatives, are among the treatment options for lateral epicondylosis. Steroid injections are performed to give symptom relief in patients with ulnar neuropathy at the elbow. Hand and wrist steroid injections are performed in case of osteoarthritis, subsequently followed by hyaluronic acid injections, and in inflammatory disorders. Wrist ganglia can be safely aspirated and injected with steroids under ultrasound guidance. De Quervain’s tenosynovitis and trigger finger are chronic tenosynovitides of the wrist and digits, respectively, which can be treated with steroid injections, subsequently followed by hyaluronic acid injections. In conclusion, proper knowledge of the musculoskeletal disorders around the elbow, hand and wrist, as well as US-guided treatment options and operator training, are prerequisites to achieve good outcomes.

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“…Women are affected more often than men, nearly three to five folds. 3 Also, it has been reported as the most common musculoskeletal disorder in most European countries and North America. In 2006, CTS was responsible for 37% of all the occupational sickness leaves and workers' compensation pay-offs.…”

Section: Introductionmentioning

confidence: 99%

<p>Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches</p>

Babaei-Ghazani¹,

Forogh²,

Raissi³

et al. 2020

JPR

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Purpose: To compare two common approaches for ultrasonography (US)-guided injection. Patients and Methods: Sixty patients with mild-to-moderate CTS were included in this double-blind randomized controlled trial (RCT). They received a single shot of corticosteroid injection through either the US-guided in-plane approach: radial or ulnar side. Participants were evaluated using Boston Carpal Tunnel Questionnaire (BCTQ) and visual analogue scale (VAS) for pain, as well as electrodiagnosis (EDX) and US parameters before the intervention, and within 12 weeks of follow-up. Results: In both groups, all outcomes, except for the electrodiagnostic measures, significantly improved within the follow-up. Pain-VAS and both subscales of BCTQ questionnaire, as our main subjective outcomes, revealed dramatic improvement, with the largest amount of changes in VAS (70%; comparing to baseline value), and about 37% for both of BQSS and BQFS scales, all indicating superiority of radial to ulnar in-plane approach. During the first follow-up, we did not detect any remarkable preference between the groups in either subjective or electrodiagnostic variables. However, there was a significant difference at next follow-up time-points in terms of VAS for pain and BQFS favoring radial approach (Table 3). Furthermore, US-measured parameters including nerve-circumference and CSA improved only in the radial in-plane group. Conclusion: The current data proved that radial in-plane approach for CTS injection could be at least as effective as the more common ulnar in-plane method. Even the pain-relief effect was longer for the radial in-plane approach. Also, patients' functional status and objective variables all revealed better outcomes via the new approach.

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Nerve Entrapment Syndromes at the Wrist and Elbow by Sonography

Cited by 24 publications

References 37 publications

Recommended musculoskeletal and sports ultrasound terminology: a Delphi-based consensus statement

Recommended musculoskeletal and sports ultrasound terminology: a Delphi-based consensus statement

Ultrasound-guided musculoskeletal interventional procedures around the elbow, hand and wrist excluding carpal tunnel procedures

<p>Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches</p>

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