Chen K-H, Lee K-F, Hsu H-C, Huang W-C, Hsiao K-Y, Fang K-M: The Role of High-Resolution Ultrasound in the Diagnosis of a Traumatic Neuroma in an Injured Median Nerve.
Since the development of high-resolution ultrasound, its role in the diagnosis of peripheral nerve lesions has steadily increased. We present the case of a 42-yr-old woman who experienced consistent numbness over the left hand and fingers after cutting the wrist in a suicide attempt and subsequent tendon and median nerve repair and a period of rehabilitation. Electrodiagnostic testing was normal, but high-resolution ultrasound demonstrated hypoechoic, focal swelling in the region of the median nerve consistent with a neuroma. Neuroma was confirmed at surgery, and after excision of the neuroma, nerve repair with a nerve graft was performed. Postoperatively, the patient's symptoms improved significantly. This case suggests that high-resolution ultrasound may be superior to electrodiagnostic studies for the diagnosis of traumatic neuroma.
From the Departments of Physical Medicine and Rehabilitation (K-HC, H-CH, K-MF), Pathology (K-FL), Plastic and Reconstructive Surgery (W-CH), and Emergency Medicine (K-YH), Chang Gung Memorial Hospital, Chiayi, Taiwan; and Graduate Institute of Clinical Medical Sciences (Chiayi Branch) (H-CH), Chang Gung University, Taoyuan, Taiwan.
All correspondence and requests for reprints should be addressed to Wei-Chao Huang, MD, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, No.6, West Sec., Chia-Pu Road, Putz City, Chiayi County 613, Taiwan.