Neuromuscular ultrasound for the differential diagnosis of radial tunnel syndrome and lateral epicondylitis

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY Journal of Neuroimaging Pub Date : 2024-10-13 DOI:10.1111/jon.13244
Antonios Kerasnoudis, Aaron Venouziou, Angelo V. Vasiliadis
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Abstract

Background and Purpose

Lateral elbow pain is quite common in everyday life. Lateral epicondylitis and radial tunnel syndrome are the most common causes of lateral elbow pain. The aim of this study was to evaluate the sensitivity and specificity of neuromuscular ultrasound examination in the diagnosis of lateral epicondylitis versus radial tunnel syndrome.

Methods

This was a prospective double-blinded pilot study of 68 elbows in 34 patients with lateral elbow pain. Patients underwent clinical examination and standardized neuromuscular ultrasound evaluation in the first 15 days after the initiation of symptoms. Statistical significance was set at p < .001. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Results

Sixty-eight radial nerves were examined in 34 healthy controls (16 males; mean age 48.1 ± 8.2 years). Pain with palpation over the radial tunnel was found in 25 of 48 elbows (52.1%) compared to the pain over the lateral epicondyle found in 10 of 48 elbows (20.8%). Τhe sensitivity of palpation in differentiating radial tunnel syndrome from lateral epicondylitis was 75.7%, while the specificity was 50% (PPV 71.4%, NPV 51.5%). The sensitivity of neuromuscular ultrasound in differentiating radial tunnel syndrome from lateral epicondylitis was 92.6%, while the specificity was 80% (PPV 92.6%, NPV 80.0%). In most of the patients (25/31), fibrous bands anterior to the radio-capitellar joint were responsible for the nerve entrapment.

Conclusions

The present study highlights the importance of the neuromuscular ultrasound's diagnostic role in differentiating radial tunnel syndrome from lateral epicondylitis in the clinical scenario of lateral elbow pain.

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神经肌肉超声对桡骨隧道综合征和外侧上髁炎的鉴别诊断。
背景和目的:肘外侧疼痛在日常生活中很常见。外上髁炎和桡骨隧道综合征是导致肘外侧疼痛的最常见原因。本研究旨在评估神经肌肉超声检查诊断外侧上髁炎和桡骨隧道综合征的敏感性和特异性:这是一项前瞻性双盲试验研究,共对34名肘外侧疼痛患者的68个肘部进行了检查。患者在出现症状后的 15 天内接受了临床检查和标准化神经肌肉超声评估。统计显著性以 p 为标准:对 34 名健康对照者(16 名男性,平均年龄为 48.1 ± 8.2 岁)的 68 条桡神经进行了检查。在 48 个肘部中,有 25 个(52.1%)在桡骨隧道处触诊时发现疼痛,而在 48 个肘部中,有 10 个(20.8%)在外侧髁处触诊时发现疼痛。触诊在区分桡骨隧道综合征和外上髁炎方面的敏感性为 75.7%,特异性为 50%(PPV 71.4%,NPV 51.5%)。神经肌肉超声在区分桡骨隧道综合征和外侧上髁炎方面的敏感性为 92.6%,特异性为 80%(PPV 92.6%,NPV 80.0%)。大多数患者(25/31)的神经卡压是由无线电腕关节前方的纤维带造成的:本研究强调了神经肌肉超声诊断在临床肘外侧疼痛中区分桡骨隧道综合征和外上髁炎的重要性。
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来源期刊
Journal of Neuroimaging
Journal of Neuroimaging 医学-核医学
CiteScore
4.70
自引率
0.00%
发文量
117
审稿时长
6-12 weeks
期刊介绍: Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!
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