High Resolution Ultrasound (HRUS) as a Diagnostic and Planning Tool in Surgical Management of Rare Chronic Neurogenous Pain Syndromes
Veith Moser, MD
Trauma Hospital, Vienna, Austria
Introduction:Chronic pain syndromes due to nerve injury, neuroma, compression or scar-related nerve traction may occur all over the body. Surgical methods, e.g. reconstruction, neuroma resection and relocation, decompression or neurolysis are often helpful, yet treatment may be missed or fail due to lack of adaquete diagnostic imaging.
Objective: This paper demonstrates the use of high-resolution nerve ultrasound imaging combined with diagnostic nerve blocks to diagnose rare nerve-related pain syndromes and shows up, how helpful this high resolution ultrasound is in diagnosing and planning the operative treatment.
Sonography with a 23 MHz head was utilized.
Results: Clinical case reports include US findings with corelating surgical findings on patients with damage to peripheral nerves are shown.
Conclusions: HRUS is a readily available, inexpensive, quick and highly versatile tool to diagnose rare causes of nerve pain. It allows an precise visalization, localization, investigation with test blocks and ink or wire marking of nerve branches with a minimal diameter of about 1 mm. Therefore, HRUS offers many significant advantages for the treating surgeon or interventional radiologist caring for neurogenous pain syndromes.
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