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Ultrasound Imaging of Median Nerve Conduit in a Patient With Persistent Median Nerve Symptoms

Billakota, Santoshi; Ruch, David S.; Hobson-Webb, Lisa D.

Journal of Clinical Neurophysiology: January 2018 - Volume 35 - Issue 1 - p e1–e2
doi: 10.1097/WNP.0000000000000386
Case Report

Summary: Peripheral nerve injury can be reconstructed using composite polymer nerve autografts, but the sonographic appearance of nerve wraps and conduits have not been well documented. This case report describes the sonographic findings in a 42-year-old woman with bilateral carpal tunnel syndrome status post nerve repair with a conduit. The cross-sectional area of the left median nerve was 24 mm2 at the carpal tunnel inlet and 5 mm2 at the forearm. The wrist to forearm ratio was 4.8. There was a hypoechoic space surrounding the nerve that was 1.8 to 1.9 mm thick and bordered by a thin, hyperechoic outer rim. On review of the operative record and consultation with her surgeon (DR), it was determined that this represented the 2-mm nerve wrap used in the last surgery. Inclusion of these structures with the median nerve measured a total area of 52 mm2 at its maximum. In describing this image, we hope to lay the foundation for describing the sonographic appearance of peripheral nerve repair.

Departments of *Neurology and

†Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A.

Address correspondence and reprint requests to Lisa D. Hobson-Webb, MD, DUMC 3403, Durham, NC 27710, U.S.A.; e-mail: lisa.hobsonwebb@duke.edu.

The authors have no funding or conflicts of interest to disclose.

© 2018 by the American Clinical Neurophysiology Society