A structured point-of-care ultrasound protocol for peripheral nerve assessment in the interventional pain medicine...

Peripheral nerve ultrasound in the pain medicine clinic remains largely non-standardized. The purpose of this technical note is to propose a structured point-of-care ultrasound protocol for systematic peripheral nerve evaluation in the interventional pain medicine setting.

The Peripheral Nerve Assessment Protocol (PNAP) was developed based on the existing peripheral nerve ultrasound literature, established point-of-care ultrasound models, and clinical experience in interventional pain medicine. The protocol targets 10 nerves across four anatomical regions using a four-step assessment sequence: static survey, dynamic provocation, Doppler interrogation, and contralateral comparison.

Sonographic diagnostic criteria and a three-tier clinical decision framework are presented to guide same-visit treatment planning. The protocol integrates diagnostic assessment with procedural decision-making within a single clinical encounter.

The PNAP provides a reproducible methodology for peripheral nerve assessment in the interventional pain medicine clinic that may serve as a foundation for future validation studies.