1. Ultrasound combined with clinical neurophysiology in peripheral nerve pathologies: When it is worth? Preliminary data in 50 outpatients

Our aim was to assess the relevance of nerve ultrasonography in a clinical neurophysiological consultation. Patients with a diagnosis of entrapment and/or post-traumatic neuropathy, but with clinical or neurophysiological unusual findings, were admitted to a nerve ultrasound (US) examination. We recruited 50 neuropathies (25M, 25F): 23 median nerves at the carpal tunnel, 1 anterior interosseous, 14 ulnar nerves at the elbow, 3 brachial plexus, 2 posterior interosseus, 1 superficial radial, 1 superficial peroneal and 4 common peroneal nerves. Overall 20/50 patients had a history of trauma: 4/23 patients with median pathology, 6/14 ulnar, 3/4 common peroneal, 1/2 posterior interosseous and all cases of involvement of the brachial plexus, superficial peroneal and superficial radial nerves. US is advisable in: (1) all patients (40%) with post-traumatic etiology (isolated or associated with other entrapments); (2) severe diseases with not evocable nerve; (3) patients with difficult to detect or diffuse neurophysiological alterations (but with clinical suspect of neuropathy); (4) entrapment neuropathies for screening of: concomitant tenosynovitis showed in 21.7% of carpal tunnel syndromes; dynamic ulnar nerve luxation at the elbow (28.5%); multiple sites of injury (radial, ulnar and posterior interosseous) in all brachial plexus pathologies.