Imaging of traumatic peripheral nerve injuries

Area of Science:

• Orthopedics
• Radiology
• Neurology

Background:

• Peripheral nerve injuries from trauma significantly impact patients, necessitating prompt management decisions.
• Conventional assessment relies on clinical findings, patient progress, and electrophysiological studies.
• Imaging modalities are crucial for localizing, grading, and monitoring recovery of nerve injuries.

Purpose of the Study:

• To discuss imaging findings in various grades of peripheral nerve injury.
• To propose a simplified 3-tier grading system for imaging assessment of nerve injuries using HUS and MRN.

Main Methods:

• High-resolution ultrasound (HUS) is the primary imaging modality for peripheral nerves.
• Magnetic resonance neurography (MRN) complements HUS, particularly for muscle changes and deeper nerves.
• Correlation of imaging findings with different injury grades based on cross-sectional nerve layers.

Main Results:

• Imaging manifestations vary with nerve injury grade.
• HUS is optimal for peripheral nerve evaluation, while MRN offers complementary insights.
• Potential overlap in imaging findings exists due to limitations in detecting ultrastructural changes.

Conclusions:

• A 3-tier grading system for HUS and MRN can standardize peripheral nerve injury assessment.
• Imaging plays a vital role in guiding management and follow-up of nerve injuries.
• Accurate grading through imaging facilitates timely and effective treatment decisions.