Ultrasonography of the tibial nerve in vasculitic neuropathy

• Published in: Muscle & Nerve Vol. 35; no. 3; pp. 379 - 382
• Main Authors: Ito, Takao, Kijima, Masanori, Watanabe, Takashi, Sakuta, Manabu, Nishiyama, Kazutoshi
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2007; Wiley
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Diagnosis, Differential; Female; Foot; Foot - innervation; Humans; Male; Medical sciences; Middle Aged; Muscle, Skeletal; Muscle, Skeletal - innervation; Muscle, Skeletal - physiopathology; nerve enlargement; Nervous system (semeiology, syndromes); Neural Conduction; Neural Conduction - physiology; Neurology; Peripheral Nervous System Diseases; Peripheral Nervous System Diseases - diagnostic imaging; Peripheral Nervous System Diseases - etiology; Peripheral Nervous System Diseases - physiopathology; Predictive Value of Tests; Prospective Studies; systemic vasculitis; Tibial Nerve; Tibial Nerve - diagnostic imaging; Tibial Nerve - pathology; Tibial Nerve - physiopathology; Tibial Neuropathy; Tibial Neuropathy - diagnostic imaging; Tibial Neuropathy - etiology; Tibial Neuropathy - physiopathology; Ultrasonography; Ultrasonography - methods; vasculitic neuropathy; Vasculitis; Vasculitis - complications; Vasculitis - diagnostic imaging; Vasculitis - physiopathology; Human; Peripheral nerve; Nervous system diseases; Tibial nerve; ultrasonography; Cardiovascular disease; Neuropathy; Vascular disease; Ankle; systemic vasculitis; Nerve conduction; Pain; Vasculitis; vasculitic neuropathy; nerve enlargement
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.20673

Ultrasonography is a new imaging method for visualizing peripheral nerves. In vasculitic neuropathy, pain or axonopathy often can prevent the lesion from being localized during electrophysiological examinations, but the ability of ultrasonography to evaluate it morphologically is unknown. Our aim was to determine whether ultrasonography could be used to detect abnormalities in tibial vasculitic neuropathy at the medial ankle. We evaluated 11 tibial nerves in 8 patients with tibial vasculitic neuropathy, and 35 tibial nerves in 35 control subjects. In the controls, the tibial nerve was successfully visualized as a hyperechoic nodule with multiple round hypoechoic areas transversely; in the patients, the tibial nerve appeared enlarged and hypoechoic. The affected nerve area was significantly larger (13.5 ± 3.7 mm2) than in controls (7.2 ± 1.5 mm2). Our results suggest that ultrasonography is a useful neuroimaging method for evaluation of tibial vasculitic neuropathy, especially when nerve conduction study findings are inconclusive. Muscle Nerve, 2006