Anatomy of Peripheral Nerve 가톨릭대학교 재활의학과 김재민
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1 Anatomy of Peripheral Nerve 가톨릭대학교 재활의학과 김재민
2 Contents US appearance of nerves Scanning technique Peripheral nerve pathology Nerves of arm Nerves of leg
3 US Appearance of Nerve Multiple longitudinal hypoechoic bands Fascicular bundle Discontinuous bands Bacigalupo L et al Radiologe 2003
4 US Appearance of Nerve Oval-to-round echogenic sections on transverse scan Internal punctate echoes Honeycomb appearance Bacigalupo L et al Radiologe 2003
5
6 US Appearance of Tendon Longitudinal scan Fibrillar pattern of parallel hyperechoic line Boundaries of collagen bundles and endotendineum septa Transverse scan Hyperechoic round to ovoid image Bright clustered dots
7 Tendon & Nerve Martinoli C et al. Eur Radiol 2002
8 Scanning Technique Lifting technique Short axial scan Oblique and longitudinal scan The focal region
9 Peripheral Nerve Pathology Neural fibrolipoma Traumatic neuroma Intraneural perineuroma Schwannoma Nerve entrapment Nerve dislocation
10 Neural Fibrolipoma Infiltration of the perineurium and epineurium with fibrofatty tissue More then 80% of cases involve the median nerve Stuart, RM. et al. Am J Roentgenol 2004
11 Traumatic Neuroma Stuart, RM. et al. Am J Roentgenol 2004
12 Intraneural Perineuroma Rare focal neuronal lesion Slowly progressive painless mononeuropathy Neoplastic perineural cell proliferation Stuart, RM. et al. Am J Roentgenol 2004
13 Schwannoma Encapsulated tumor Within epineurium Stuart, RM. et al. Am J Roentgenol 2004
14 Nerve Entrapment - Ulnar
15 Nerve Entrapment Syndrome Nerve shape and echotexure Flattening Focal reduction at compression region Swelling proximal at the level of compression Size measurement Abnormal findings in the nerve surroundings Mass, anomalous muscle, synovitis etc. Innerved muscles to identify denervation sign
16 Nerve Dislocation
17 Sonography in Neuropathies
18 Nerves of Arm Musculocutaneous nerve Dorsal scapular nerve Suprascapular nerve Axillary nerve Radial nerve Ulnar nerve Median nerve
19 Musculocutaneous Nerve
20 Musculocutaneous Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
21 Suprascapular Nerve Ganglion cyst Lipomas Tumor Anomalous vein Traction injury Inflammation Hochman MG et al. Radiol Clin North Am 2004
22 Axillary Nerve Trauma Glenohumeral dislocation Fracture of humerus Hematoma Paralabral cyst Teres minor hypertrophy Martinoli C et al. J Clin Ultrasound 2004
23 Radial Nerve
24 Radial Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
25 Radial Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
26 Ulnar Nerve
27 Ulnar Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
28 Ulnar Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
29 Cubital Tunnel Microtrauma Bony deformity Ganglion cyst Mass Synovitis Variant anconeus epitrochlearis m.
30 Ulnar Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
31 Guyon s Cannel Martinoli C et al. Radiographics 2000
32 Median Nerve
33 Median Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
34 Median Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
35 Median Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
36 Median Nerve Kiloh-Nevin syndrome Trauma Vascular anomalies Tendiosis Fibrous band Anomalus muscle Mass Bicipital bursa Carpal tunnel syndrome Overuse Inflammatory arthritis Swelling related to thyroid disease, dialysis, pregnancy Ganglion cyst lipoma Tumor Gouty tophi Anomalous musculature
37 Carpal Tunnel Martinoli C et al. Radiographics 2000
38 Nerves of Leg Femoral nerve Obturator nerve Sciatic nerve Peroneal nerve Tibial nerve
39 Femoral & Obturator Nerves
40 Sciatic Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
41 Sciatic Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
42 Peroneal Nerve At fibular head Fracture Hemorrhage Tight cast or boot Synovial, ganglion, meniscal cyst Soft tissue tumor
43 Peroneal Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
44 Tibial Nerve
45 Tibial Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
46 Tibial Nerve Manaster BJ et al. Diagnostic and surgical imaging anatomy. 2006
47 Tibial Nerve In popliteal fossa Popliteal cyst Popliteal muscle rupture Tarsal tunnel syndrome Morton s neuroma
48 Tarsal Tunnel Syndrome Bony impingement Ganglion cyst Neurilemoma Tenosynovitis Accessory or hypertrophic muscle Martinoli C et al. Radiographics 2000
49 Morton s Neuroma Nerve degeneration Endoneurial edema Perineurial fibrosis Martinoli C et al. Radiographics 2000
50 Nerve Compression Syndrome
51 Thank you for your attention!
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Disclaimer This movie is an educational resource only and should not be used to manage Orthopaedic Health. All decisions about must be made in conjunction with your Physician or a licensed healthcare provider.