Sonographic evaluation of pediatric traumatic peripheral nerve injuries

Ultrasound offers distinct advantages over MRI in the assessment of upper extremity nerve injuries in children. The radiologist has the advantage of direct visualization and physical examination, as well as dynamic maneuvers to reproduce nerve symptoms. Image acquisition is generally faster than MRI and does not require sedation as the patient does not need to be motionless. MRI of small nerves requires long scan times for adequate resolution, while ultrasound offers time-independent enhanced resolution over MRI. Ultrasonographic findings can discriminate high-grade from low-grade nerve injuries and these correlate with intraoperative findings. Moreover, ultrasound can accurately characterize nerve anatomy and thereby guide management.