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The major peripheral nerves supplying motor and sensory function to the forearm and hand traverse the elbow joint. The complex anatomical relationships of these nerves to the joint and its surrounding musculotendinous structures creates a series of sites where these nerves are vulnerable to compression. Compression syndromes result in distressing constellations of pain, paraesthesia, weakness and loss of coordinated motor function. This article discusses the anatomy and pathophysiology of compressive neuropathies around the elbow joint, their presentation, how they are investigated and diagnosed, and the available management options. [ABSTRACT FROM AUTHOR]

Nerve entrapment syndromes about the elbow are not uncommon and are often diagnostically challenging. An understanding of the anatomy of the relevant nerves is paramount in recognition of various presentations and in the localization of nerve compression sites. A precise diagnosis must be based on a thorough history and physical examination, imaging and neurophysiological studies. An initial attempt at non-operative measures is the mainstay of treatment. In recalcitrant cases, tailoring the nerve decompression surgery according to clinical suspicion can help optimize the operative outcomes. [ABSTRACT FROM AUTHOR]

All three major peripheral nerves to the forearm and hand traverse the elbow joint. Each nerve has a complex pathway intertwining between and around the other soft tissue structures around the joint that allow stability and mobility. Each nerve glides freely in a pulleyed tunnel that allows both efficiency of motion and provides soft tissue protection. The symptoms of nerve entrapment and compression vary with each nerve depending on the degree of compression and the nature of the nerve fascicles involved: altered sensation; tingling; weakness; pain. This article discusses entrapment syndromes of the median, ulnar and radial nerves at the elbow including cubital tunnel syndrome, radial tunnel syndrome, posterior interosseous nerve compression, anterior interosseous nerve compression and pronator syndrome. The anatomical course, clinical features, investigations and treatment strategies for management are all considered. [ABSTRACT FROM AUTHOR]

Background: Lower back pain (LBP) remains a common ailment among adult populations and a superior cluneal nerve (SCN) entrapment accounts for 10% of reported LBP cases. The diagnostic criteria for SCN entrapment include anaesthesia of the area supplied by the SCN after performing a nerve block. Several surgical reports describe the anatomy of the SCN but purely anatomical studies of the course of the SCN are rare. This study aimed to describe the location of the SCN in relation to easily identifiable bony landmarks. Methods: The SCN was identified as it pierced the thoracolumbar fascia and crossed over the posterior part of the iliac crest on both sides of 27 adult cadavers. A sliding dial calliper was used to measure the distance from the posterior superior iliac spine (PSIS) to the SCN and from the midline lumbar spinous processes to the nerve. Results: The PSIS to SCN measurement was found to be 69.6 ± 15.0 mm (mean ± SD) while the midline to SCN measurement was 72.1 ± 10.2 mm. Discussion: This study showed clear gender differences in the PSIS to SCN measurement, due to the sexual dimorphism of the bony pelvis. There was also found to be a positive correlation between the height of the sample and the distances of the SCN from both the midline and PSIS. This study provides a clear anatomical description of the course of the SCN as it crosses the iliac crest, which will allow for the successful identification of the SCN. [ABSTRACT FROM AUTHOR]

Résumé: Les syndromes canalaires au pied sont très rares. Le plus connu est le syndrome du tunnel tarsien. Il correspond à la compression du nerf tibial, sous le ligament retinaculum des fléchisseurs à la cheville, ou de ses branches terminales. Il ne s’agit pas à proprement parler d’un véritable syndrome canalaire idiopathique comme pour le syndrome du canal carpien. Il résulte le plus souvent de lésions post-traumatiques ou de déformations du pied. Les formes idiopathiques existent, mais pour certains, restent de réalité discutable. Le diagnostic en est souvent difficile. L’examen électroneuromyographique est de loin moins performant que pour le nerf médian au canal carpien. Les autres syndromes canalaires sont encore plus rares. Il peut s’agir des branches terminales du nerf tibial : plantaire médial et latéral, des nerfs calcanéens, des extrémités distales des nerfs fibulaires profonds et superficiels. Le névrome de Morton peut y être rattaché. [Copyright &y& Elsevier]

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Abstract: Purpose: The purpose of this study is to evaluate the use of multislice computed tomography (MCT), Doppler US, and angiography in the diagnosis of popliteal artery entrapment syndrome. Patients and methods: In a prospective study of 26 patients referred to Doppler ultrasound examination with suspected popliteal artery entrapment syndrome, we have made Doppler study of the popliteal artery of the diseased limb using 7–10MHz probe. Additional multislice CT angiography after bolus injection of non-ionic contrast medium (Ultravist), axial transverse sections and multiplanar reformation reconstruction images were analyzed. Conventional angiography of the diseased limb was performed with the use of pigtail catheter and injection of 60cc Ultravist. Results: On 22 of 26 patients, the Doppler study revealed damped flow, biphasic waves and a dramatic decrease in peak velocity. All these signs appeared in the Doppler study of popliteal artery while retaining normal flow and waves in distal tibial vessels. When 26 patients were examined, the conventional angiography revealed sudden attenuated and decreased caliber of popliteal artery with retained average caliber of the distal run-off vessels without showing the surrounding structures. When 26 patients were examined, the CT angiography revealed decreased caliber of popliteal artery, verified the exact diameter of popliteal artery and gave an accurate idea about the wall of the vessels and the surrounding soft tissue structures. These last benefits enable us to differentiate between organic and functional causes of popliteal artery entrapment syndrome. Conclusion: In conclusion, popliteal artery entrapment syndrome can be diagnosed with the use of multislice CT which is as efficient as conventional angiography. However, multislice CT provides detailed information on the wall, diameter of the artery and relation of the artery to adjacent structures by a non-invasive technique. [Copyright &y& Elsevier]