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Posterior interosseous neuropathy: Supinator syndrome vs fascicular radial neuropathy.
- Source :
-
Neurology [Neurology] 2016 Nov 01; Vol. 87 (18), pp. 1884-1891. Date of Electronic Publication: 2016 Sep 28. - Publication Year :
- 2016
-
Abstract
- Objective: To investigate the spatial pattern of lesion dispersion in posterior interosseous neuropathy syndrome (PINS) by high-resolution magnetic resonance neurography.<br />Methods: This prospective study was approved by the local ethics committee and written informed consent was obtained from all patients. In 19 patients with PINS and 20 healthy controls, a standardized magnetic resonance neurography protocol at 3-tesla was performed with coverage of the upper arm and elbow (T2-weighted fat-saturated: echo time/repetition time 52/7,020 milliseconds, in-plane resolution 0.27 × 0.27 mm <superscript>2</superscript> ). Lesion classification of the radial nerve trunk and its deep branch (which becomes the posterior interosseous nerve) was performed by visual rating and additional quantitative analysis of normalized T2 signal of radial nerve voxels.<br />Results: Of 19 patients with PINS, only 3 (16%) had a focal neuropathy at the entry of the radial nerve deep branch into the supinator muscle at elbow/forearm level. The other 16 (84%) had proximal radial nerve lesions at the upper arm level with a predominant lesion focus 8.3 ± 4.6 cm proximal to the humeroradial joint. Most of these lesions (75%) followed a specific somatotopic pattern, involving only those fascicles that would form the posterior interosseous nerve more distally.<br />Conclusions: PINS is not necessarily caused by focal compression at the supinator muscle but is instead frequently a consequence of partial fascicular lesions of the radial nerve trunk at the upper arm level. Neuroimaging should be considered as a complementary diagnostic method in PINS.<br /> (© 2016 American Academy of Neurology.)
- Subjects :
- Adolescent
Adult
Aged
Brachial Plexus diagnostic imaging
Brachial Plexus pathology
Case-Control Studies
Electromyography
Female
Forearm diagnostic imaging
Forearm innervation
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Middle Aged
Movement Disorders diagnostic imaging
Movement Disorders etiology
Muscle, Skeletal diagnostic imaging
Prospective Studies
Radial Neuropathy classification
Radial Neuropathy complications
Young Adult
Forearm pathology
Muscle, Skeletal pathology
Radial Neuropathy diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1526-632X
- Volume :
- 87
- Issue :
- 18
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 27683851
- Full Text :
- https://doi.org/10.1212/WNL.0000000000003287