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2012 ; 12
(51
): 463-71
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Ultrasound assessment of selected peripheral nerves pathologies Part II:
Entrapment neuropathies of the lower limb
#MMPMID26673938
Kowalska B
; Sudo?-Szopi?ska I
J Ultrason
2012[Dec]; 12
(51
): 463-71
PMID26673938
show ga
Similarly to entrapment neuropathies of upper extremities, the ultrasound
constitutes a valuable supplementation of diagnostic examinations performed in
patients with suspicions of nerve entrapment syndromes of the lower limb. For
many years, it was claimed that such pathologies were rare. This probably
resulted from the lack of proper diagnostic tools (including high frequency
ultrasound transducers) as well as the lack of sufficient knowledge in this area.
In relation to the above, the symptoms of compression neuropathies were
frequently interpreted as a manifestation of pathologies of the lumbar part of
the spine or a other orthopedic disease (degenerative or overuse one).
Consequently, many patients were treated ineffectively for many months and even,
years which led to irreparable neurological changes and changes in the motor
organ. Apart from a clinical examination, the diagnostics of entrapment
neuropathies of lower limb is currently based on imaging tests (ultrasound,
magnetic resonance) as well as functional assessments (electromyography).
Magnetic resonance imaging is characterized by a relatively low resolution (as
compared to ultrasound) which results in limited possibilities of morphological
evaluation of the visualized pathology. Electromyography allows for the
assessment of nerve function, but does not precisely determine the type and
degree of change. This article presents examples of the most common entrapment
neuropathies of the lower limb concerning the following nerves: sciatic, femoral,
lateral femoral cutaneous, obturator, fibular and its branches, tibial and its
branches as well as sural. The pathomorphological basis of the neuropathies as
well as corresponding ultrasound images are presented in this paper. Attention
has been drawn to echogenicity, degree of vascularization and bundle presentation
of the trunk of a pathological peripheral nerve.
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