Ultrasound Imaging of the Deep Peroneal Nerve

Becciolini, Marco; Pivec, Christopher; Riegler, Georg

doi:10.1002/jum.15455

Cited by 16 publications

(18 citation statements)

References 44 publications

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“…Assessment of increased cross‐sectional area (CSA) of the peroneal nerve, a measurement for the nerve's surface at one specific two‐dimensional slice, was routinely performed in all articles on US, reflecting the importance of this diagnostic parameter [69,70]. Even single fascicular involvement can be assessed with CSA measurements [42].…”

Section: Resultsmentioning

confidence: 99%

Evidence in peroneal nerve entrapment: A scoping review

Oosterbos

Decramer

Rummens

et al. 2021

Euro J of Neurology

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Background and purpose Daily management of patients with foot drop due to peroneal nerve entrapment varies between a purely conservative treatment and early surgery, with no high‐quality evidence to guide current practice. Electrodiagnostic (EDX) prognostic features and the value of imaging in establishing and supplementing the diagnosis have not been clearly established. Methods We performed a literature search in the online databases MEDLINE, Embase, and the Cochrane Library. Of the 42 unique articles meeting the eligibility criteria, 10 discussed diagnostic performance of imaging, 11 reported EDX limits for abnormal values and/or the value of EDX in prognostication, and 26 focused on treatment outcome. Results Studies report high sensitivity and specificity of both ultrasound (varying respectively from 47.1% to 91% and from 53% to 100%) and magnetic resonance imaging (MRI; varying respectively from 31% to 100% and from 73% to 100%). One comparative trial favoured ultrasound over MRI. Variable criteria for a conduction block (>20%–≥50) were reported. A motor conduction block and any baseline compound motor action potential response were identified as predictors of good outcome. Based predominantly on case series, the percentage of patients with good outcome ranged 0%–100% after conservative treatment and 40%−100% after neurolysis. No study compared both treatments. Conclusions Ultrasound and MRI have good accuracy, and introducing imaging in the standard diagnostic workup should be considered. Further research should focus on the role of EDX in prognostication. No recommendation on the optimal treatment strategy of peroneal nerve entrapment can be made, warranting future randomized controlled trials.

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Section: Resultsmentioning

confidence: 99%

Evidence in peroneal nerve entrapment: A scoping review

Oosterbos

Decramer

Rummens

et al. 2021

Euro J of Neurology

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Section: General Considerations and Us Requisites For Rn Evaluationmentioning

confidence: 97%

“…The US appearance of nerves is well described in the pertinent literature and is, therefore, only mentioned briefly in the present pictorial: nerves appear as hypoechoic fascicles with surrounding hyperechoic tissue, resulting in a typical honeycomb structure. 3,5,10 The transducer frequency required is generally 12-15 MHz, except for those of larger body habitus in whom the frequency may need to be lowered, with a loss in resolution. We suggest completing the examination with higher-frequency probes (≥17 MHz) if the nerves to be examined are superficial (eg, to follow the distal course of the SBRN, and to better depict the RN at the radial groove, particularly in slender patients).…”

Section: General Considerations and Us Requisites For Rn Evaluationmentioning

confidence: 99%

Ultrasound of the Radial Nerve: A Pictorial Review

Becciolini¹,

Pivec²,

Raspanti

et al. 2021

J of Ultrasound Medicine

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This pictorial review focuses on the ultrasound (US) appearance of the normal and pathological radial nerve (RN) and its branches and provides tips with which to locate them and avoid misinterpretation of normal findings. A wide range of our pathological cases are reviewed and presented to help in familiarizing the reader with common and uncommon clinical scenarios that affect the RN and its main branches.

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“…In traumatic causes, including direct contusion, traction injury, penetrating injury, and also post-surgical iatrogenic events, the DPN appears swollen and edematous, with hypoechoic thickening in US 33 with an increased T2W SI and decreased T1W SI in MRI. If partial or complete disruption of the nerve occurs, post-traumatic or stump neuroma may be seen in US as a hypoechoic mass-like lesion 28,33 and in MRI with an iso-to low T1W SI and iso-to high T2W SI with enhancement. 37,38 Other traumatic causes include compartment syndrome in the anterior or lateral fascial compartments 39,40 and compression from a fractured bone fragment or late sequelae of heterotopic ossification.…”

Section: Traumatic Pathology Of the Dpnmentioning

confidence: 99%

Deep Peroneal Nerve: From an Anatomical Basis to Clinical Implementation

et al. 2022

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The deep peroneal nerve (DPN) is considered one of the clinically significant nerves of the lower extremity since several clinical abnormalities can commonly be caused by its defects, either in its sensory or motor functions. Its derivatives, classified as muscular, cutaneous, and articular, mainly supply the muscles in the anterior fascial compartment of the leg and the dorsum of the foot, the 1st dorsal web space of the foot, the ankle joint, and certain joints of the foot. To improve the effectiveness of clinical practices involving the DPN, it is important to first understand its anatomical nature, including its typical characteristics and the variants (orientation, branching, and analogous structure), prior to applying such practices in clinical implementation. This review, therefore, aims to review the previously studied information of DPN on its fundamental anatomy and link it to the provided examples of current commonly used procedures, both non-invasive and invasive, e.g., nerve imaging, nerve block, neuroelectrophysiological study, and free autologous tissue transfer, thereby giving an integrated view in the translational medicine of DPN. Conclusively, the ultimate goal of this review is to help maximize the therapeutic effectiveness and to minimize the unanticipated complications of any clinical practices involving the DPN by inferring from its anatomical knowledge.

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Ultrasound Imaging of the Deep Peroneal Nerve

Cited by 16 publications

References 44 publications

Evidence in peroneal nerve entrapment: A scoping review

Evidence in peroneal nerve entrapment: A scoping review

Ultrasound of the Radial Nerve: A Pictorial Review

Deep Peroneal Nerve: From an Anatomical Basis to Clinical Implementation

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