Role of Ulnar Nerve Sonography in Leprosy Neuropathy With Electrophysiologic Correlation

Abstract

Sonography and electrophysiology were complementary for identifying ulnar nerve neuropathy in patients with leprosy, with clinical symptoms as the reference standard. This reinforces the role of sonography in the investigation of leprosy ulnar neuropathy.

New sonographic measures of peripheral nerves: a tool for the diagnosis of peripheral nerve involvement in leprosy

“…3B) suggest that sonographic evaluation of the T region can be a useful tool for detecting neural involvement in leprosy. According to Elias Jr et al (2009), the best sonographic discriminator for the ulnar nerve in LPs is the CSA of the ulnar nerve measured in the elbow region and not only at the cubital T. Consistent with this suggestion, the T-CSAs in this study had significantly higher values than the PT-CSAs (p < 0.0001) in HVs, while these measurements were similar in LPs.…”

“…In a study by Elias Jr et al (2009), the sonographic examination of three patients showed ulnar nerve thickening without electrophysiological nerve abnormalities, indicating that an affected peripheral nerve may function normally. If a sonographic finding is highly suggestive of leprosy neuropathy, it may play an important role in detecting neuropathy.…”

“…Considering the polymorphic aspect of leprosy neuropathy, diagnosis may be difficult even in countries with high incidence rates. Clinical findings, electrophysiological tests and nerve sonographic characteristics of leprosy neuropathy have been described previously (Grimaud et al 2000, Martinoli et al 2000, Marques et al 2003, Arruda et al 2004, Elias Jr et al 2009, Bathala et al 2012.…”

“…Recently, sonography has been described as a useful tool in the diagnosis of leprosy neuropathy. A highly correlated finding is a fusiform thickening of the peripheral nerves that are generally compromised in leprosy patients (LPs), including the ulnar, median (M) and posterior tibial nerves, which can be measured by the corresponding cross-sectional areas (CSAs) of the affected regions (Martinoli et al 2000, Elias Jr et al 2009.…”

Ultrasonography and magnetic resonance imaging of ulnar nerve abscess in leprosy

“…9 Involved nerves reveal focal thickening (more marked proximal to the medial epicondyle), hypoechoic focal areas (granulomata), peripheral hyperechogenicity (epineural fibrosis), abscesses and increased vascularity on colour-Doppler imaging (in lepra reactions). 2,9 Elias et al 2 have proposed that altered neural anatomy on sonography with preserved electrophysiological tests is highly suggestive of leprosy and may be useful in evaluating asymptomatic household contacts.…”