Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis
Background: High-resolution ultrasound of the tibial nerve has been used for screening of several neurologic disorders, but normative reference values of tibial nerve cross-sectional areas (CSA) have not been well established. Thus, the present meta-analysis was performed to generate normative estim...
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/19/6186 |
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| author | Thanyaporn Senarai Athikhun Suwannakhan Thongchai Pratipanawatr Kaissar Yammine Laphatrada Yurasakpong Tanapat Sathapornsermsuk Sirorat Janta Achiraya Kittiboonya |
| author_facet | Thanyaporn Senarai Athikhun Suwannakhan Thongchai Pratipanawatr Kaissar Yammine Laphatrada Yurasakpong Tanapat Sathapornsermsuk Sirorat Janta Achiraya Kittiboonya |
| author_sort | Thanyaporn Senarai |
| collection | DOAJ |
| description | Background: High-resolution ultrasound of the tibial nerve has been used for screening of several neurologic disorders, but normative reference values of tibial nerve cross-sectional areas (CSA) have not been well established. Thus, the present meta-analysis was performed to generate normative estimates of tibial nerve CSA at various sites of the lower limb based on ultrasonography. Methods: Google Scholar, Scopus and PubMed were searched for potential studies. Studies were required to report tibial nerve CSA in healthy individuals to be included. A random-effect meta-analysis was performed to calculate tibial nerve CSA values. Subgroup and statistical analyses were performed to study covariates. Results: Forty-eight eligible articles consisting of 2695 limbs were included. The average tibial nerve CSA was found to be 10.9 mm<sup>2</sup> at the ankle (95% CI: 9.9–11.8) and should not exceed 11.8 mm<sup>2</sup> in healthy adults. At the popliteal fossa, the overall CSA was 21.7 mm<sup>2</sup> (95% CI: 17.5–25.8) in healthy adults. At both sites, the average tibial nerve CSA was significantly larger in adults than in children, and the differences by geographical region were not statistically significant. At the ankle, tibial nerve CSA increased with age and body mass index, while at the popliteal fossa it increased with age and weight. Conclusions: our findings indicate that the tibial nerve varied not only along its course but also among sub-variables. Establishing normal references values of tibial nerve CSA is helpful to differentiate healthy from diseased tibial nerves such as in diabetic peripheral neuropathy or tarsal tunnel syndrome. |
| first_indexed | 2024-03-10T21:41:58Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:41:58Z |
| publishDate | 2023-09-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-a536905eeefc413293d2c279fd6625062023-11-19T14:35:17ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011219618610.3390/jcm12196186Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-AnalysisThanyaporn Senarai0Athikhun Suwannakhan1Thongchai Pratipanawatr2Kaissar Yammine3Laphatrada Yurasakpong4Tanapat Sathapornsermsuk5Sirorat Janta6Achiraya Kittiboonya7Microscopy Unit, Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, ThailandDepartment of Anatomy, Faculty of Science, Mahidol University, Bangkok 10400, ThailandDepartment of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, ThailandDepartment of Orthopedic and Trauma Surgery, Lebanese American University Medical Center—Rizk Hospital, Beirut 11-3288, LebanonDepartment of Anatomy, Faculty of Science, Mahidol University, Bangkok 10400, ThailandMahidol University International College, Salaya, Nakhon Pathom 73170, ThailandAnatomy Unit, Department of Medical Science, Faculty of Science, Rangsit University, Pathumthani 12000, ThailandCentre for Anatomy and Human Identification (CAHID), School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UKBackground: High-resolution ultrasound of the tibial nerve has been used for screening of several neurologic disorders, but normative reference values of tibial nerve cross-sectional areas (CSA) have not been well established. Thus, the present meta-analysis was performed to generate normative estimates of tibial nerve CSA at various sites of the lower limb based on ultrasonography. Methods: Google Scholar, Scopus and PubMed were searched for potential studies. Studies were required to report tibial nerve CSA in healthy individuals to be included. A random-effect meta-analysis was performed to calculate tibial nerve CSA values. Subgroup and statistical analyses were performed to study covariates. Results: Forty-eight eligible articles consisting of 2695 limbs were included. The average tibial nerve CSA was found to be 10.9 mm<sup>2</sup> at the ankle (95% CI: 9.9–11.8) and should not exceed 11.8 mm<sup>2</sup> in healthy adults. At the popliteal fossa, the overall CSA was 21.7 mm<sup>2</sup> (95% CI: 17.5–25.8) in healthy adults. At both sites, the average tibial nerve CSA was significantly larger in adults than in children, and the differences by geographical region were not statistically significant. At the ankle, tibial nerve CSA increased with age and body mass index, while at the popliteal fossa it increased with age and weight. Conclusions: our findings indicate that the tibial nerve varied not only along its course but also among sub-variables. Establishing normal references values of tibial nerve CSA is helpful to differentiate healthy from diseased tibial nerves such as in diabetic peripheral neuropathy or tarsal tunnel syndrome.https://www.mdpi.com/2077-0383/12/19/6186tibial nerveultrasoundsonographyreference valuessystematic reviewmeta-analysis |
| spellingShingle | Thanyaporn Senarai Athikhun Suwannakhan Thongchai Pratipanawatr Kaissar Yammine Laphatrada Yurasakpong Tanapat Sathapornsermsuk Sirorat Janta Achiraya Kittiboonya Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis Journal of Clinical Medicine tibial nerve ultrasound sonography reference values systematic review meta-analysis |
| title | Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis |
| title_full | Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis |
| title_fullStr | Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis |
| title_short | Normative Reference Values of the Tibial Nerve in Healthy Individuals Using Ultrasonography: A Systematic Review and Meta-Analysis |
| title_sort | normative reference values of the tibial nerve in healthy individuals using ultrasonography a systematic review and meta analysis |
| topic | tibial nerve ultrasound sonography reference values systematic review meta-analysis |
| url | https://www.mdpi.com/2077-0383/12/19/6186 |
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