Nerve entrapment upper limb

Paul Mastragostino, Chadwick Chung
Objective: To present the clinical case of a patient with an upper extremity superficial venous thrombosis (SVT), and to highlight the importance for clinicians working in musculoskeletal care settings, to considered non-musculoskeletal causes for their patients' presentations. Clinical Features: A 31-year-old male presented to an academic chiropractic clinic with progressive left sided tension over the medial arm, extending to the anterior aspect of his proximal forearm...
April 2020: Journal of the Canadian Chiropractic Association
Milton Helfenstein Júnior
To present the clinical features of less common entrapment neuropathies of upper limbs, introduce diagnostic tools, comment on the general bases of treatment, and create awareness of these conditions. Although these conditions are rare, adequate and rapid diagnosis is necessary to initiate appropriate treatment in a timely manner, in order to avoid further nerve insults, associated muscle atrophy, and their consequences in quality of life.
April 21, 2020: Best Practice & Research. Clinical Rheumatology
Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar
In amputees, the majority of residual limb pain ensues due to neuroma(s). Recently, high-resolution ultrasound (US) has substantially facilitated the morphological evaluation of nerves and the surrounding soft tissues/scars contributory in entrapment syndromes. We reported a 57-year-old male, who had received below-knee amputation due to osteomyelitis three years ago, was seen for continuous stabbing and burning sensation at the left residual limb. US examination showed that the terminal end of the deep peroneal nerve was enlarged and encircled by hypoechoic scars...
April 1, 2020: Pain Practice: the Official Journal of World Institute of Pain
Oliver Lotter, Tobias Lieb, Viktor Breul, Jochen Molsner
To assess the prevalence of upper extremity work-related musculoskeletal disorders (WMSDs) among surgical device mechanics compared to a control group, a total of 70 employees were included and assigned to three occupational groups (grinders, packers, and control). Personal factors, work exposure, manual skill, and complaints were assessed by two self-administered questionnaires and an industry test. WMSDs were diagnosed in a standardised clinical examination. The two-one-sided t -tests (TOST) procedure was used to test the clinical equivalence of the respective grinding and packaging groups vs...
February 21, 2020: International Journal of Environmental Research and Public Health
Suresh Narayanan, Priyadharshini Nattalam Adikesavan
In literature, the presence of the supracondylar process, fibrous band enclosing the neurovascular structures, and the additional head of pronator teres have been reported as isolated reports. In this article, we describe three unique variations observed in the left upper limb of a 63-year-old female cadaver, (1) the variant origin of pronator teres from the supracondylar process, (2) the variant course of the median nerve and brachial artery passing through a fibrous tunnel in the lower third of the arm, later behind the supracondylar process and the variant pronator teres, and (3) the higher origin of radial artery from the brachial artery in the arm...
January 6, 2020: Surgical and Radiologic Anatomy: SRA
Federica Rossi, Bianca Bignotti, Lorenzo Bianchi, Riccardo Picasso, Carlo Martinoli, Alberto Stefano Tagliafico
OBJECTIVE: To assess the discriminative power of radiomics of peripheral nerves at 1.5T MRI, using common entrapment neuropathies of the upper limb as a model system of focal nerve injury. MATERIALS AND METHODS: Radiomics was retrospectively done on peripheral nerve fascicles on T1-weighted 1.5T MRI of 40 patients with diagnosis of mild carpal (n = 25) and cubital tunnel (n = 15) syndrome and of 200 controls. Z-score normalization and Mann-Whitney U test were used to compare features of normal and pathological peripheral nerves...
November 26, 2019: La Radiologia Medica
Anasuya Ghosh, Subhramoy Chaudhury
The knowledge about detailed morphology and relation of saphenous nerve is important to obtain successful saphenous nerve regional blocks to achieve pre- and post-operative anesthesia and analgesia, nerve entrapment treatments and to avoid damage of saphenous nerve during knee and ankle surgeries. The literature describing detailed morphology of saphenous nerve is very limited. We dissected 42 formalin fixed well embalmed cadaveric lower limbs to explore detailed anatomy, relation and mode of termination of saphenous nerve and measured the distances from the nearby palpable bony landmarks...
September 2019: Anatomy & Cell Biology
Mohammad Hasan Bahrami, Seyed Ahmad Raeissadat, Mohammadrasoul Nezamabadi, Fateme Hojjati, Shahram Rahimi-Dehgolan
Purpose: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper limb. Local injection of different substances has been increasingly used as an acceptable conservative treatment in non-severe cases. This study aimed to evaluate the efficacy and safety of local ozone injection in the management of non-severe CTS. Methods: In the current randomized controlled trial (RCT), 40 patients with mild or moderate CTS were included in two parallel groups. Both of them used the resting volar wrist splint for 8 weeks; while the intervention group received a single dose of local ozone injection, except for the same splinting protocol...
2019: Orthopedic Research and Reviews
Diony Klokkari, Ioannis Mamais
Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb. Treatment options include physiotherapy, splinting, steroid injections or surgery. Objective: To compare the effectiveness of surgical versus conservative treatment for CTS for symptom and functional improvement and improvement of neurophysiological parameters. Methods: Systematic searches of PubMed and EBSCO host were conducted to identify the studies published between 1990 and 2016, comparing any surgical treatment to any conservative treatment...
December 2018: Hong Kong Physiotherapy Journal
Ankita Aggarwal, Manisha Jana, Deep N Srivastava, Raju Sharma, Shivanand Gamanagatti, Atin Kumar, Vijay Kumar, Rajesh Malhotra, Kanwaljeet Garg
Peripheral neuropathy is defined as any disease or damage to the peripheral nerves. Imaging modalities are emerging as a complementary tool of choice for diagnosis of peripheral neuropathies. This has been made possible by the advent of high-resolution ultrasound, higher field strength magnets, better surface array coils, and superior software. In addition, imaging plays a pivotal role in deciding the management. They help in determining the continuity and course of the nerve, thereby helping in the pre-surgical mapping of nerve...
January 2019: Neurology India
Xiaowei Jing, Zhiyuan Gong, Ning Zhang, Gang Chen, Fangcai Li, Qixin Chen, Zhengkuan Xu, Rui Zhang
Traumatic incarceration of the small bowel accompanied by vertebral fractures and dislocation is rare and usually misdiagnosed until laparotomy. This report presents a rare case of jejunum entrapment between lumbar spine fractures. A 43-year-old man was clamped between two railway tracks on the upper abdomen and lower back. Following ineffective conservative treatment, he underwent a laparotomy due to the development of guarding and rebound tenderness. Loss of vitality of the jejunal loop, which was incarcerated between the L3 and L4 vertebrae, was observed...
January 8, 2019: Journal of International Medical Research
Reza Salman Roghani, Seyed Ebrahim Hashemi, Mohammad Taghi Holisaz, Faeze Gohari, Ahmad Delbari, Johan Lokk
Background: Accurate diagnosis of carpal tunnel syndrome (CTS), the most common entrapment neuropathy, and its differentiation from other diseases are essential, especially in older individuals with advanced symptoms and modified electrophysiological abnormalities. The current study was conducted to evaluate the diagnostic accuracy of ultrasonography (US), regarding sensitivity and specificity in the diagnosis of CTS in elderly patients. Methods: Individuals with upper limb complaints and reference subjects were recruited from the Rofaydeh Hospital, Tehran, Iran, from June 2013 to October 2014 - (15 months)...
2018: Clinical Interventions in Aging
Ignazio G Vetrano, Davide Bagatti, Roberto Cordella, Irene Tramacere, Vittoria Nazzi
BACKGROUND: Decompression and, when necessary, neurolysis in entrapment neuropathies of upper limbs are effective and safe procedures, but their correlation with the variation of compound muscle action potentials (CMAPs) is still unclear, based in particular on experimental models. In addition, there are few data regarding the efficacy of intraoperative neurophysiologic monitoring (IOM) to predict clinical early and late outcome after surgery in term of pain control and sensitive/motor recovery...
August 28, 2018: Journal of Neurosurgical Sciences
Cheng-Yin Tan, Thaarani Arumugam, Siti Nur Omaira Razali, Mohd Azly Yahya, Khean-Jin Goh, Nortina Shahrizaila
Diabetic patients with poor glycaemic control can demonstrate demyelinating distal sensorimotor polyneuropathy (D-DSP) on electrophysiology. Distinguishing D-DSP from chronic inflammatory demyelinating polyneuropathy (CIDP) can be challenging. In this study, we investigated the role of nerve ultrasound in differentiating the two neuropathies. Nerve ultrasound findings of D-DSP patients (fulfilling the electrophysiological but not clinical criteria for CIDP) were compared with non-diabetic CIDP patients (fulfilling both criteria)...
November 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sudarshan Anandkumar
This case report describes a 45-year-old male who presented with chronic right lateral elbow pain managed unsuccessfully with conservative treatment that included anti-inflammatory medication, injection, massage, exercise, bracing, taping, electro-physical agents, and manual therapy. Diagnosis of radial tunnel syndrome (RTS) was based on palpatory findings, range of motion testing, resisted isometrics, and a positive upper limb neural tension test 2b (radial nerve bias). Conventionally, the intervention for this entrapment has been surgical decompression, with successful outcomes...
April 2019: Physiotherapy Theory and Practice
Angela Burian, Othmar Schuhfried, Richard Crevenna
PURPOSE: To describe the clinical manifestation and the treatment of complex regional pain syndrome type II in childhood. METHODS: Using information on the symptoms, diagnosis, rehabilitation and outcome of a young patient with complex regional pain syndrome type II. RESULTS: A 9-year -old girl had severe pain in the region of the left foot, signs of a common fibular nerve entrapment, hyperalgesia not limited to the distribution of the injured nerve, weakness and temperature asymmetry unknown origin...
December 7, 2017: Disability and Rehabilitation
Beatriz Mansilla, Alberto Isla, María Román de Aragón, Borja Hernández, Pablo García Feijoo, Alexis Palpán Flores, Susana Santiago
OBJECTIVE: Intraneural cysts are benign lesions located within the epineurium of some peripheral nerves and their aetiopathogenesis is controversial. Most are located at the level of the lower limbs. In the upper limbs, the most frequently affected nerve is the ulnar nerve. Suprascapular nerve entrapment syndrome due to the formation of an intraneural cyst is rare. In this article, we show a new case and perform a literature review of intraneural cysts located in the suprascapular nerve...
September 2018: Neurocirugía
Kazutoshi Kubo, Yu-Shiuan Cheng, Boran Zhou, Kai-Nan An, Steven L Moran, Peter C Amadio, Xiaoming Zhang, Chunfeng Zhao
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy occurring in upper limbs. The etiology, however, has not been fully understood yet. Median nerve could be compressed by either increase of carpal tunnel pressure (CTP) or direct impingement when it is forced toward to carpal ligament especially in wrist flexion leading to CTS development. Thus, the increase of carpal tunnel pressure is considered an important role in CTS development. It has been identified that forces applied to the palm would affect the CTP...
January 3, 2018: Journal of Biomechanics
Gian Maria Fabrizi, Stefano Tamburin, Tiziana Cavallaro, Ilaria Cabrini, Moreno Ferrarini, Federica Taioli, Francesca Magrinelli, Giampietro Zanette
OBJECTIVE: Nerve ultrasound (US) data on myelin protein zero (MPZ)-related Charcot-Marie-Tooth disease (CMT) are lacking. To offer a comprehensive perspective on MPZ-related CMTs, we combined nerve US with clinics, electrodiagnosis and histopathology. METHODS: We recruited 36 patients (12 MPZ mutations), and correlated nerve US to clinical, electrodiagnostic measures, and sural nerve biopsy. RESULTS: According to motor nerve conduction velocity (MNCV) criteria, nine patients were categorized as "demyelinating" CMT1B, 17 as "axonal" CMT2I/J, and 10 as dominant "intermediate" CMTDID...
January 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Meral Bilgilisoy Filiz, Tuncay Cakir, Naciye Fusun Toraman, Sebnem Koldas DoGan, Iclal Erdem Toslak, Hilmi Uysal
Hirayama disease (HD) was first reported by Hirayama et al. in 1959. The disease is considered as a type of benign focal motor neuron disease that primarily affects upper limbs of young males. In this case report, we present a man aged 40-years with rapidly progressive weakness and atrophy in his left hand. The findings of nerve conduction studies were consistent with left ulnar neuropathy at the elbow. Flexion magnetic resonance imaging (MRI) revealed minimal enlargement of the posterior epidural space and anterior displacement of the spinal cord...
August 2017: JPMA. the Journal of the Pakistan Medical Association
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