Sonographic Evaluation of Site Specific Nerve Dimensions in Young Asymptomatic Adults: A Cross-sectional Study
Introduction: Tibial Nerve (TN) and Common Peroneal Nerve (CPN) supply the muscles and skin of lower extremity via their major branches and also send articular branches to the joints of lower extremity. Knowledge of nerve dimensions is useful for diagnosis of pathologies, planning nerve blocks,...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2022-01-01
|
| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | https://www.ijars.net/articles/PDF/2736/50138_CE[Ra1]_F(SHU)_PF1(AKA_RK)_PN(KM).pdf |
| Summary: | Introduction: Tibial Nerve (TN) and Common Peroneal Nerve
(CPN) supply the muscles and skin of lower extremity via their
major branches and also send articular branches to the joints
of lower extremity. Knowledge of nerve dimensions is useful for
diagnosis of pathologies, planning nerve blocks, biopsies or
other therapeutic procedures.
Aim: To assess bilateral Tibial Nerve (TN) and Deep Peroneal
Nerve (DPN) morphology and morphometry at ankle through a
sonographic evaluation.
Materials and Methods: A cross-sectional, observational study
was conducted in the Department of Anatomy, King George’s
Medical University, Lucknow, Uttar Pradesh, India from September
2018 to August 2019. Morphology and morphometry of TN and
DPN was observed by High Resolution Ultrasonography (HRUS)
at specific anatomical site in 100 first year Bachelor in Medicine
and Bachelor in Surgery (MBBS) students (50 males and 50
females). The nerve parameters like, Cross-sectional Area (CSA),
nerve perimeter and depth from skin were measured and the data
was analysed statistically. Among asymptomatic subjects, various
nerve parameters and subcutaneous depth were observed in both
genders to establish normal reference values for the purpose of
creating database. The association of nerve parameter to Body
Mass Index (BMI) was also studied. To compare the change in a
parameter at two different time intervals, paired t-test was used. To
test the significance of two means, the Student’s t-test was used.
Results: Amongst the total 100 subjects, 50 were males and 50
females with age range 17-25 years. Mean CSA, perimeter and
DFS (depth from skin) of TN was 9.6±1.02 mm2
, 9.95±0.78 mm
and 9.7±1.13 mm, respectively, whereas the DPN mean
CSA, perimeter and subcutaneous depth was 8.0±1.05 mm2
,
8.5±1.12 mm and 9.0±0.98 mm, respectively. The CSA and
perimeter of right TN was significantly (p-value=0.004) greater
than left. DPN mean CSA (p-value=0.008) and perimeter
(p-value <0.001) were significantly greater on the right side in
comparison to left. The TN was significantly deeper in location
in females (p<0.004). DPN was significantly deeper in females
than males (p<0.001). Differences in nerve parameters among
subjects in relation to were insignificant.
Conclusion: Nerve parameters were conveniently measured by
ultrasound. Knowledge of site-specific normal size of nerves is of
great importance in diagnosing various neuropathies, compression
syndromes and traumatic nerve lesions. In current study, we have
attempted to create a reference database that may be valuable for
neurologists as well as radiologists. Knowledge of nerve depth and
location may help in guiding ankle blocks in various surgeries and
for other diagnostic and therapeutic purposes. |
|---|---|
| ISSN: | 2277-8543 2455-6874 |