Neuromuscular Ultrasound

Abstract

Accurate assessment of neuromuscular disorders is critical to facilitate timely treatment and achieve the best outcomes. Historically, electrodiagnostic studies have filled this role, but recently, neuromuscular ultrasound is being used in the electrodiagnostic laboratory. This review discusses the uses of neuromuscular ultrasound in the electrodiagnostic laboratory that have strong evidence, emphasizing those that could be adopted in a typical electrodiagnostic laboratory with a reasonable level of equipment and training. The evidence currently supports using neuromuscular ultrasound to diagnose carpal tunnel syndrome and ulnar neuropathies at the elbow and as a supplementary test when electrodiagnostic studies are suspected to be falsely negative or in axonal nonlocalizing lesions. Neuromuscular ultrasound can identify the causes of focal mononeuropathies, which can change treatment in specific cases. It is sensitive at identifying fasciculations and providing complementary evidence of autoimmune demyelinating polyneuropathies. It is particularly helpful in assessing nerves after trauma. Neuromuscular ultrasound is likely to prove even more useful in the electrodiagnostic laboratory as the technology continues to advance.

The use and misuse of sonographic reference values in neuromuscular disease

“…Neuromuscular ultrasound is an evolving subspecialty within the field of clinical neurophysiology that is applied in the diagnostic workup of an increasing number of disorders of diverse etiology. 1 Ultrasound can provide a practical and efficient complement to the electrodiagnostic studies (EDx) routinely deployed in patients with a suspected neuromuscular disorder. 2 Just as with EDx, the use of neuromuscular ultrasound requires adequate training, including knowledge of the human neuromuscular anatomy, consideration of the relevant technical factors and appropriate clinical context, 3 and proper interpretation of the results.…”

“…Neuromuscular ultrasound is an evolving subspecialty within the field of clinical neurophysiology that is applied in the diagnostic workup of an increasing number of disorders of diverse etiology 1 . Ultrasound can provide a practical and efficient complement to the electrodiagnostic studies (EDx) routinely deployed in patients with a suspected neuromuscular disorder 2 .…”

Neuromuscular ultrasound standardized scanning techniques and protocols: Expert panel recommendations

“…It has demonstrated significant utility in entrapment neuropathies, traumatic nerve injuries, brachial plexopathies, and generalized nerve and muscle diseases. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Parallel to the continuous expansion of clinical applications, the number of publications related to neuromuscular ultrasound has increased markedly in the past decade. 3 Despite the growing utility of neuromuscular ultrasound, the scanning approaches for common disorders vary among publications.…”

“…The role of neuromuscular ultrasound in the diagnostic evaluation of various neuromuscular disorders is not yet fully defined and continues to evolve. It has demonstrated significant utility in entrapment neuropathies, traumatic nerve injuries, brachial plexopathies, and generalized nerve and muscle diseases 1–19 . Parallel to the continuous expansion of clinical applications, the number of publications related to neuromuscular ultrasound has increased markedly in the past decade 3 .…”