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Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Routine knee MRI: how common are peripheral nerve abnormalities, and why does it matter?

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Peripheral nerve abnormalities, though uncommon on knee MRI, are frequently observed in the common peroneal nerve (CPN) and can impact patient management. Over a third of identified cases required surgical intervention, highlighting their clinical significance.

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Area of Science:

  • Radiology
  • Neurology
  • Orthopedics

Background:

  • Peripheral nerve abnormalities (PNAs) are occasionally identified during routine knee magnetic resonance imaging (MRI).
  • Understanding their frequency, appearance, and clinical relevance is crucial for accurate diagnosis and patient management.

Purpose of the Study:

  • To determine the incidence, MRI characteristics, and clinical significance of PNAs detected on knee MRI.
  • To assess the association between PNAs and other knee pathologies, such as ligament and meniscal tears.

Main Methods:

  • Retrospective review of 8125 knee MRIs performed between March 2015 and 2018.
  • Identification and characterization of PNAs in the tibial (TN) and common peroneal nerves (CPN), including hyperintensity, enlargement, discontinuity, distortion, and denervation.
  • Documentation of concomitant meniscal, cruciate, and collateral ligament tears; recording of patient demographics and clinical outcomes.

Main Results:

  • Fifty knee MRIs (0.6% of total) revealed PNAs, predominantly in the CPN (80%) compared to the TN (30%).
  • Common findings included hyperintensity and bulbous enlargement; skeletal muscle denervation was also noted.
  • PNAs were frequently associated with meniscal and ligamentous tears, including ACL, PCL, and collateral ligaments. Of patients with PNAs, 32% were treated for peripheral nerve injury (PNI), with 36% undergoing surgical treatment.

Conclusions:

  • Peripheral nerve abnormalities are an uncommon but significant finding on routine knee MRI, with CPN involvement being more frequent.
  • These abnormalities can influence patient management, with a notable percentage requiring surgical intervention.
  • The presence of PNAs warrants careful evaluation for associated knee injuries and consideration for further nerve-specific management.