Subscribe to RSS
DOI: 10.1055/s-0030-1263259
Nerve Entrapment and Compression Syndromes of the Elbow
Publication History
Publication Date:
08 September 2010 (online)
ABSTRACT
Nerve compression and entrapment syndromes are classic examples of the integrated role of radiologists and clinicians in achieving difficult but accurate diagnoses. The pathology of nerves can only be understood after evaluating the normal architecture and imaging characteristics of nerves. Understanding the correlation of the pathophysiology of nerve compromise with electromyographic findings and imaging findings allows for greater comprehension of a difficult topic. Particularly in the elbow, there are multiple potential areas of nerve entrapment and compression that can be evaluated perhaps best with magnetic resonance imaging.
KEYWORDS
Nerve compression and entrapment syndromes - elbow - MRI
REFERENCES
- 1 Maravilla K R, Bowen B C. Imaging of the peripheral nervous system: evaluation of peripheral neuropathy and plexopathy. AJNR Am J Neuroradiol. 1998; 19(6) 1011-1023
- 2 Lundborg G, Dahlin L B. The pathophysiology of nerve compression. Hand Clin. 1992; 8(2) 215-227
- 3 Hochman M G, Zilberfarb J L. Nerves in a pinch: imaging of nerve compression syndromes. Radiol Clin North Am. 2004; 42(1) 221-245
- 4 Wright T W, Glowczewskie Jr F, Cowin D, Wheeler D L. Ulnar nerve excursion and strain at the elbow and wrist associated with upper extremity motion. J Hand Surg [Am]. 2001; 26(4) 655-662
- 5 Dahlin L B. Aspects on pathophysiology of nerve entrapments and nerve compression injuries. Neurosurg Clin N Am. 1991; 2(1) 21-29
- 6 Tomaino M M. Radial tunnel release: true entrapment neuropathy or mainly a pain operation?. Curr Opin Orthop. 2000; 11 246-249
- 7 Lubahn J D, Cermak M B. Uncommon nerve compression syndromes of the upper extremity. J Am Acad Orthop Surg. 1998; 6(6) 378-386
- 8 Dang A C, Rodner C M. Unusual compression neuropathies of the forearm, part I: radial nerve. J Hand Surg [Am]. 2009; 34(10) 1906-1914
- 9 Uetani M, Hayashi K, Matsunaga N, Imamura K, Ito N. Denervated skeletal muscle: MR imaging. Work in progress. Radiology. 1993; 189(2) 511-515
- 10 Kikuchi Y, Nakamura T, Takayama S, Horiuchi Y, Toyama Y. MR imaging in the diagnosis of denervated and reinnervated skeletal muscles: experimental study in rats. Radiology. 2003; 229(3) 861-867
- 11 Koltzenburg M, Bendszus M. Imaging of peripheral nerve lesions. Curr Opin Neurol. 2004; 17(5) 621-626
- 12 Hartz C R, Linscheid R L, Gramse R R, Daube J R. The pronator teres syndrome: compressive neuropathy of the median nerve. J Bone Joint Surg Am. 1981; 63(6) 885-890
- 13 Grant G A, Britz G W, Goodkin R, Jarvik J G, Maravilla K, Kliot M. The utility of magnetic resonance imaging in evaluating peripheral nerve disorders. Muscle Nerve. 2002; 25(3) 314-331
- 14 Chiou H J, Chou Y H, Chiou S Y, Liu J B, Chang C Y. Peripheral nerve lesions: role of high-resolution US. Radiographics. 2003; 23(6) e15
- 15 Kim S, Choi J Y, Huh Y M et al.. Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity. Eur Radiol. 2007; 17(1) 139-149
- 16 Kijowski R, Tuite M, Sanford M. Magnetic resonance imaging of the elbow. Part II: Abnormalities of the ligaments, tendons, and nerves. Skeletal Radiol. 2005; 34(1) 1-18
- 17 Bordalo-Rodrigues M, Rosenberg Z S. MR imaging of entrapment neuropathies at the elbow. Magn Reson Imaging Clin N Am. 2004; 12(2) 247-263, vi
- 18 Husarik D B, Saupe N, Pfirrmann C WA, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology. 2009; 252(1) 148-156
- 19 Aagaard B D, Lazar D A, Lankerovich L et al.. High-resolution magnetic resonance imaging is a noninvasive method of observing injury and recovery in the peripheral nervous system. Neurosurgery. 2003; 53(1) 199-203, discussion 203–204
- 20 Yamabe E, Nakamura T, Oshio K, Kikuchi Y, Ikegami H, Toyama Y. Peripheral nerve injury: diagnosis with MR imaging of denervated skeletal muscle—experimental study in rats. Radiology. 2008; 247(2) 409-417
- 21 Andreisek G, Crook D W, Burg D, Marincek B, Weishaupt D. Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 2006; 26(5) 1267-1287
- 22 West G A, Haynor D R, Goodkin R et al.. Magnetic resonance imaging signal changes in denervated muscles after peripheral nerve injury. Neurosurgery. 1994; 35(6) 1077-1085; discussion 1085–1086
- 23 McDonald C M, Carter G T, Fritz R C, Anderson M W, Abresch R T, Kilmer D D. Magnetic resonance imaging of denervated muscle: comparison to electromyography. Muscle Nerve. 2000; 23(9) 1431-1434
- 24 Dunn A J, Salonen D C, Anastakis D J. MR imaging findings of anterior interosseous nerve lesions. Skeletal Radiol. 2007; 36(12) 1155-1162
- 25 Nagano A. Spontaneous anterior interosseous nerve palsy. J Bone Joint Surg Br. 2003; 85(3) 313-318
- 26 Childress H M. Recurrent ulnar-nerve dislocation at the elbow. Clin Orthop Relat Res. 1975; 108(108) 168-173
- 27 Gellman H. Compression of the ulnar nerve at the elbow: cubital tunnel syndrome. Instr Course Lect. 2008; 57 187-197
- 28 Gelberman R H, Yamaguchi K, Hollstien S B et al.. Changes in interstitial pressure and cross-sectional area of the cubital tunnel and of the ulnar nerve with flexion of the elbow. An experimental study in human cadavera. J Bone Joint Surg Am. 1998; 80(4) 492-501
- 29 Britz G W, Haynor D R, Kuntz C et al.. Ulnar nerve entrapment at the elbow: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings. Neurosurgery. 1996; 38(3) 458-465; discussion 465
- 30 Ferdinand B D, Rosenberg Z S, Schweitzer M E et al.. MR imaging features of radial tunnel syndrome: initial experience. Radiology. 2006; 240(1) 161-168
- 31 Fuss F K, Wurzl G H. Radial nerve entrapment at the elbow: surgical anatomy. J Hand Surg [Am]. 1991; 16(4) 742-747
- 32 Tsai P, Steinberg D R. Median and radial nerve compression about the elbow. Instr Course Lect. 2008; 57 177-185
- 33 Portilla Molina A E, Bour C, Oberlin C, Nzeusseu A, Vanwijck R. The posterior interosseous nerve and the radial tunnel syndrome: an anatomical study. Int Orthop. 1998; 22(2) 102-106
- 34 Mileti J, Largacha M, O'Driscoll S W. Radial tunnel syndrome caused by ganglion cyst: treatment by arthroscopic cyst decompression. Arthroscopy. 2004; 20(5) e39-e44
- 35 Chien A J, Jamadar D A, Jacobson J A, Hayes C W, Louis D S. Sonography and MR imaging of posterior interosseous nerve syndrome with surgical correlation. AJR Am J Roentgenol. 2003; 181(1) 219-221
- 36 Hashizume H, Nishida K, Nanba Y, Shigeyama Y, Inoue H, Morito Y. Non-traumatic paralysis of the posterior interosseous nerve. J Bone Joint Surg Br. 1996; 78(5) 771-776
- 37 Sisco M, Dumanian G A. Anterior interosseous nerve syndrome following shoulder arthroscopy. A report of three cases. J Bone Joint Surg Am. 2007; 89(2) 392-395
- 38 Seror P. Anterior interosseous nerve lesions. Clinical and electrophysiological features. J Bone Joint Surg Br. 1996; 78(2) 238-241
- 39 Grainger A J, Campbell R SD, Stothard J. Anterior interosseous nerve syndrome: appearance at MR imaging in three cases. Radiology. 1998; 208(2) 381-384
Eric A BognerM.D.
Department of Radiology and Imaging, Hospital for Special Surgery
535 E. 70th St., New York, NY 10021
Email: bognere@hss.edu