Ultrasound‐Derived Nerve Cross‐Sectional Area in Extremes of Height and Weight

Abstract

BACKGROUND AND PURPOSE There is a lack of consensus in the literature as to which body habitus parameter most influences nerve cross‐sectional area (CSA). This study was specifically designed to determine if height or weight is more influential. METHODS Fifteen young healthy participants, 8 extremely tall and 7 heavy, with no peripheral nerve symptoms were recruited. The tall cohort consisted of males who were 74 inches or taller and females who were 68 inches or taller. The heavy cohort consisted of males who were 274 lbs or heavier and females who were 200 lbs or heavier. Measurements were obtained bilaterally at 7 sites using neuromuscular ultrasound: median nerve at the wrist and mid‐forearm, ulnar at the elbow, radial at the spiral groove, fibular at the knee, tibial at the ankle, and sural at the ankle. The nerve CSA at each site was measured by tracing of the nerve using the “freehand” trace function of the ultrasound device. RESULTS Weight tightly correlated with nerve CSA (R2 = .69, P < .001), while height did not significantly predict CSA (R2 = .10, P = .244). Nerve CSA for tall participants did not systematically deviate from an historical control group. Conversely, with exception of the tibial and sural nerves at the ankle, all nerve CSAs for heavy participants were higher than in the control group. CONCLUSION Weight was found to be the body habitus parameter that most influences nerve CSA. This will inform clinicians when using nerve imaging to evaluate participants at either extreme of weight.

Sural Nerve Size in Fibromyalgia Syndrome: Study on Variables Associated With Cross-Sectional Area

“…Body weight itself is also another factor that can affect peripheral nerve CSA. However, compared to other nerves, sural nerve CSA is the one that seems to be less affected by this variable (22).…”

Computer-assisted measurements of the histological structure of the tibial nerve and its terminal branches

“…Lothet et al [24] together with Cartwright et al [7] proved that in the medial ankle ultrasound examination the tibial nerve CSA remains uninfluenced by the patient's height and weight. In the present study the authors confirm that CSA of the tibial nerve increases with the advanced age, which is consistent with the findings of Grimm et al [12] and Cartwright et al [6].…”

“…The other cause of slight variation may be related to a different level of measurements. Lothet et al [24] together with Kang et al [18], Kerasnoudis et al [19], Cartwright et al [7], Bedewi et al [3], Boehm et al [5] and Grimm et al [12] performed the examination at the level of the ankle whilst He et al [13] and Singh et al [30] measured the CSA 3 cm above the medial malleolus and Riazi et al [27] 1 cm, 3 cm and 5 cm above the medial malleolus. As the tibial nerve bifurcation level shows great topographic variability, such inaccuracy may bring different results.…”

“…It causes heel and sole burning pain and paraesthesia [2]. Such disorders together with other peripheral nerve pathologies may be examined by the ultrasound [24]. The cross-sectional area (CSA) is a parameter measured by the ultrasound which increasing value confirms the diagnosis [7].…”

Dermatome Mapping Test in the analysis of anatomo-clinical correlations after inguinal hernia repair

“…From this review, it is clear that nerve identification during hernia repair is more difficult than in cadaver studies, and greatly depends on the preparedness, expertise and skills of the surgeon [20,21]. Some studies have tried to find a correlation between BMI (weight) age and cross-sectional area of nerves of the upper and lower limbs [22][23][24]. In our experience (II 82.6%, IH 72% and GF 48.7%) was in line with the precedent literature.…”