-
The British Journal of Radiology Jan 2023High resolution ultrasound (US) and magnetic resonance (MR) neurography are both imaging modalities that are commonly used for assessing peripheral nerves including the... (Review)
Review
High resolution ultrasound (US) and magnetic resonance (MR) neurography are both imaging modalities that are commonly used for assessing peripheral nerves including the sural nerve (SN). The SN is a cutaneous sensory nerve which innervates the lateral ankle and foot to the base of the fifth metatarsal. It is formed by contributing nerves from the tibial and common peroneal nerves with six patterns and multiple subtypes described in literature. In addition to the SN being a cutaneous sensory nerve, the superficial location enables the nerve to be easily biopsied and harvested for a nerve graft, as well as increasing the susceptibility to traumatic injury. As with any peripheral nerves, pathologies such as peripheral nerve sheath tumors and neuropathies can also affect the SN. By utilizing a high frequency probe in US and high-resolution MR neurography, the SN can be easily identified even with the multiple variations given the standard distal course. US and MRI are also useful in determining pathology of the SN given the specific image findings that are seen with peripheral nerves. In this review, we evaluate the normal imaging anatomy of the SN and discuss common pathologies identified on imaging.
Topics: Humans; Sural Nerve; Peroneal Nerve; Ankle; Lower Extremity; Ankle Joint; Magnetic Resonance Imaging
PubMed: 36039944
DOI: 10.1259/bjr.20220336 -
Seminars in Neurology Oct 2019Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a... (Review)
Review
Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a comprehensive knowledge of these conditions, especially in neurology and orthopedic surgery clinical practices. Detailed knowledge of topographic anatomy, clinical manifestations, and appropriate use of electrophysiological studies with selective addition of neuromuscular ultrasonography are needed to establish an early and accurate diagnosis to advice patients and provide them with a comprehensive treatment plan. In this article, we discuss the most common forms of entrapment neuropathies in the upper and lower extremities.
Topics: Humans; Nerve Compression Syndromes; Peroneal Nerve; Radial Nerve; Tibial Nerve; Ultrasonography
PubMed: 31639838
DOI: 10.1055/s-0039-1693004 -
Journal of Orthopaedic Trauma Dec 2020
Topics: Humans; Iatrogenic Disease; Paralysis; Peroneal Nerve
PubMed: 32925452
DOI: 10.1097/BOT.0000000000001964 -
Plastic and Reconstructive Surgery.... Apr 2023Schwannomas are benign tumors of the nerve sheath that arise from the proliferation of active peripheral Schwann cells. Although schwannomas are the most common benign...
Schwannomas are benign tumors of the nerve sheath that arise from the proliferation of active peripheral Schwann cells. Although schwannomas are the most common benign peripheral nerve sheath tumors, superficial peroneal nerve schwannomas are rare in published works of literature. We report a 45-year-old woman with a 4-year history of progressively worsening dull aching pain and paresthesia over the right lateral leg. Physical examination revealed a 4 × 3 cm firm palpable mass and a decreased touch and pain sensation over the lateral aspect of the right calf and dorsum of the foot. She also had an electric shock-like pain on palpation and percussion of the mass. Magnetic resonance imaging demonstrated a well-defined, oval, smooth-walled heterogeneous lesion beneath the peroneus muscle with avid postcontrast enhancement and a split fat sign. Fine needle aspiration cytology also suggested the diagnosis of schwannoma. Based on clinical findings of a mass, decreased sensation, and a positive Tinel sign on the dermatome of superficial peroneal nerve, surgical management was decided. Upon surgical exploration, a firm, glistening mass arising from the superficial peroneal nerve was identified, carefully dissected, and shelled out while maintaining continuity of the nerve. At the 5-month follow-up, the patient reported complete resolution of the pain and paresthesia. Physical examination revealed intact sensation in the lower lateral aspect of the right calf and dorsum of the foot. Therefore, surgical excision should be considered a reasonable option in the management of this rare condition, with most patients achieving good to excellent results.
PubMed: 37101609
DOI: 10.1097/GOX.0000000000004950 -
Aktuelle Urologie Sep 2023
Topics: Humans; Peroneal Nerve; Urinary Bladder, Overactive
PubMed: 37611597
DOI: 10.1055/a-2056-2768 -
Nederlands Tijdschrift Voor Geneeskunde May 2024A dropping foot is the consequence of a variety of debilitating conditions and is oftentimes treated conservatively by general practitioners and other specialists.... (Review)
Review
A dropping foot is the consequence of a variety of debilitating conditions and is oftentimes treated conservatively by general practitioners and other specialists. Typically, it is caused by peroneal nerve palsy secondary to compression or a hernia nucleosipulpei at the level L4-L5. Identifying the underlying pathology requires a neurological work-up oftentimes including ultrasound and electromyographic investigation. When a peroneal nerve compression is found, decompression can be achieved operatively. Should the underlying cause of the dropping foot have been treated adequately without an effect on the foot itself, then a posterior tibial tendon transfer may be considered. Generally, a posterior tibial tendon transfer has good outcomes for the treatment of dropping foot although it is partly dependent on the physiotherapy that accompanies it.
Topics: Humans; Peroneal Neuropathies; Gait Disorders, Neurologic; Tendon Transfer; Decompression, Surgical; Treatment Outcome
PubMed: 38747585
DOI: No ID Found -
Journal of Ultrasound in Medicine :... Apr 2021Ultrasound is considered an excellent imaging modality to evaluate the nerves of the limbs. The deep peroneal nerve (DPN) is one of the terminal branches of the common... (Review)
Review
Ultrasound is considered an excellent imaging modality to evaluate the nerves of the limbs. The deep peroneal nerve (DPN) is one of the terminal branches of the common peroneal nerve. The DPN may be affected by various disorders, which may be clinically challenging to show. This Pictorial Essay reviews the normal ultrasound anatomy of the DPN and presents disorders that may involve the nerve and its main branches along its course, from proximal to distal.
Topics: Cadaver; Humans; Peroneal Nerve; Ultrasonography
PubMed: 32881065
DOI: 10.1002/jum.15455