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The Role of High-Resolution Ultrasound in the Diagnosis of a Traumatic Neuroma in an Injured Median Nerve

Chen, Kai-Hua MD; Lee, Kam-Fai MD; Hsu, Hung-Chih MD; Huang, Wei-Chao MD; Hsiao, Kuang-Yu MD; Fang, Kuan-Ming MD

American Journal of Physical Medicine & Rehabilitation: September 2009 - Volume 88 - Issue 9 - p 771-774
doi: 10.1097/PHM.0b013e3181b332ef
Case Report: Ultrasound

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.

Disclosures: None.

Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.