Annals of Rehabilitation Medicine

"Hanboram Choi"

Original Articles

Could Ultrasound-Guided Stimulation of Sural Nerve Affect Nerve Conduction Study?: Hanboram Choi, Seong Yun Chung, Seok Kang, Seong-Ho Son, Joon Shik Yoon; Ann Rehabil Med 2019;43(1):74-80. Published online February 28, 2019; DOI: https://doi.org/10.5535/arm.2019.43.1.74

Abstract
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Objective
To determine anatomical variation of the sural nerve (SN) by ultrasonography (US) and compare sensory nerve action potential (SNAP) of the SN obtained by a control method to that obtained with adjusted method using US.
Methods
Eighty legs of 40 healthy volunteers were enrolled. The location and formation of SN were investigated through US. Two methods of nerve conduction study (NCS) were then performed. In the control method, the cathode was placed 14 cm proximal to the lateral malleolus and the greatest SNAP amplitude was obtained by moving the cathode medially or laterally from just lateral to the calf-mid line. In adjusted NCS, the exact SN union site was stimulated in type 1. In other SN types, the stimulation was done directly over the nerve and the distance from the lateral malleolus was set to be 14 cm.
Results
It was found that 73.8% of the SNs were type 1, 22.5% were direct continuation of MSCN (type 2), and 3.8% were MSCN and LSCN without communicating (type 4). However, type 3 was not found. The union point in type 1 SN was 12.6±2.5 cm proximal to the lateral malleolus and 1.4±0.7 cm lateral to the calf-midline. After stimulation adjustment, SNAP amplitude in type 1 SN was significantly increased (20.7±5.5 μV vs. 27.1±6.7 μV).
Conclusion
Anatomical variation of SN and its location were verified by US. US provides additional information for conducting sural NCS and helps obtain more accurate results.

Citations

Citations to this article as recorded by

The value of ultrasound-guidance of nerves and muscles for patient tolerance and parameters electrodiagnostic studies
Marie Laure Inghilleri, Sandrine Alonso, Hélène Moron, Hector Ruiz, Sophie Bastide, Sarah Coudray
Clinical Neurophysiology Practice.2024; 9: 78. CrossRef
An overview of neuromuscular ultrasound of important small nerves
Eman A. Tawfik
Egyptian Rheumatology and Rehabilitation.2024;[Epub] CrossRef
Anatomical patterns of the sural nerve: a meta-analysis with clinical and surgical considerations
Diogo Costa Garção, Maria Stephany de Souza Paiva, Karolaine Santos Corcinio
Surgical and Radiologic Anatomy.2023; 45(6): 681. CrossRef
Variations in sural nerve formation and course in fetuses
Diogo Costa Garção, Maria Stephany de Souza Paiva, Karolaine Santos Corcinio
Neurosurgical Review.2023;[Epub] CrossRef
The Application of Ultrasound Guidance in Electrodiagnostic Studies – A Narrative Review
Kuo-Chang Wei, Chueh-Hung Wu, Tyng-Guey Wang
Journal of Medical Ultrasound.2023; 31(4): 263. CrossRef

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Carpal Tunnel Syndrome Assessment With Ultrasonography: A Comparison Between Non-diabetic and Diabetic Patients: Chung Ho Lee, Hanboram Choi, Joon Shik Yoon, Seok Kang; Ann Rehabil Med 2018;42(1):85-91. Published online February 28, 2018; DOI: https://doi.org/10.5535/arm.2018.42.1.85

Abstract
PDF

Objective

To investigate the diagnostic value of cross-sectional area (CSA) and wrist to forearm ratio (WFR) in patients with electro-diagnosed carpal tunnel syndrome (CTS) with or without diabetes mellitus (DM).

Methods

We retrospectively studied 256 CTS wrists and 77 healthy wrists in a single center between January 1, 2008 and January 1, 2013. The CSA and WFR were calculated for each wrist. Patients were classified into four groups according to the presence of DM and CTS: group 1, non-DM and non-CTS patients; group 2, non-DM and CTS patients; group 3, DM and non-CTS patients; and group 4, DM and CTS patients. To determine the optimal cut-off value, receiver operating characteristic (ROC) curve analysis was performed.

Results

The CSA and WFR were significantly different among the groups (p<0.001). The ROC curve analysis of non-DM patients revealed CSA ≥10.0 mm² and WFR ≥1.52 as the most powerful diagnostic values of CTS. The ROC curve analysis revealed CSA ≥12.5 mm² and WFR ≥1.87 as the most powerful diagnostic values of CTS.

Conclusion

Ultrasonographic assessment for the diagnosis of CTS requires a particular cut-off value for diabetic patients. Based on the ROC analysis results, improved accurate diagnosis is possible if WFR can be applied regardless of presence or absence of DM.

Citations

Citations to this article as recorded by

Diabetes Increases Median Nerve Cross-Sectional Area but Not Disease Severity in Patients with Carpal Tunnel Syndrome
Colin H. Beckwitt, William Schulz, Sabrina Carrozzi, Jeffrey Wera, Karen Wasil, John R. Fowler
Journal of Hand and Microsurgery.2024; 16(2): 100030. CrossRef
Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study
Dougho Park, Sang-Eok Lee, Jae Man Cho, Joong Won Yang, ManSu Kim, Heum Dai Kwon
BMC Musculoskeletal Disorders.2023;[Epub] CrossRef
Can ultrasound imaging be used for the diagnosis of carpal tunnel syndrome in diabetic patients? A systemic review and network meta-analysis
Ing-Jeng Chen, Ke-Vin Chang, Yueh-Ming Lou, Wei-Ting Wu, Levent Özçakar
Journal of Neurology.2020; 267(7): 1887. CrossRef
Comparison of Ultrasound Findings of Carpal Tunnel Syndrome before and after Corticosteroid Injection
Hamid Golmohammadi, Hossein Saremi, Abbas Moradi, Shadi Pakmehr, Masoud Esnaashari
Avicenna Journal of Clinical Medicine.2020; 26(4): 193. CrossRef
Diagnostic potential of ultrasound in carpal tunnel syndrome with different etiologies: correlation of sonographic median nerve measures with electrodiagnostic severity
Basant Elnady, Elsayed M. Rageh, Tohamy Ekhouly, Sabry M. Fathy, Mohamed Alshaar, El Saeed Fouda, Mohammed Attar, Ahmed M. Abdelaal, Ahmed El Tantawi, Mohammed M. Algethami, David Bong
BMC Musculoskeletal Disorders.2019;[Epub] CrossRef