Ultrasound-Guided Nerve Hydrodissection for Sural Nerve Injury: A Case Report and Review of the Literature

Sural nerve entrapment is a relatively uncommon cause of lateral ankle and foot pain and sensory disturbance. Conventional management generally lacks direct, targeted intervention at the site of nerve injury. We report a case of a 33-year-old male patient who developed sural neuropathy secondary to a right ankle sprain. Diagnosis was confirmed by electromyography (EMG) and high-resolution musculoskeletal ultrasonography (US). The patient underwent two sessions of ultrasound-guided perineural hydrodissection, achieving over 80% pain relief posttreatment, with sustained stability during follow-up. This case highlights the diagnostic synergy of EMG and US in peripheral nerve entrapment syndromes, enabling precise diagnosis and anatomical localization of the entrapment site. It also supports ultrasound-guided hydrodissection as a precise, safe, minimally invasive, and effective therapeutic intervention that may obviate the need for invasive surgery.