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Semin Musculoskelet Radiol 2010; 14(2): 227-235
DOI: 10.1055/s-0030-1253162
© Thieme Medical Publishers

Muscle Denervation and Nerve Entrapment Syndromes

Howard R. Galloway1
  • 1Department of Human Movement, University of Queensland, Richmond Surrey, United Kingdom
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Publication History

Publication Date:
18 May 2010 (online)

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ABSTRACT

Nerve entrapment and muscle denervation syndromes are often hard to diagnose, presenting as pain or unusual weakness. In addition many of the clinically named syndromes are poorly defined and understood. An understanding of the clinical signs, the normal and variant anatomy, and the often variable relationship between the imaging findings and the clinical findings is essential in the accurate diagnosis and management of these disorders. MRI has proved sensitive to the presence of muscle denervation and can provide high resolution imaging along the course of the major nerves allowing demonstration of mass lesions or normal anatomical variations. The diagnosis of nerve entrapment and muscle denervation syndromes can be a substantial clinical challenge. Imaging, particularly MRI, can prove very useful in confirming a nerve lesion by demonstrating changes of muscle denervation. Identification of the muscles involved combined with knowledge of the normal patterns of innervation and their variations can allow localization of the site of the nerve lesion.

KEYWORDS

Muscle denervation - nerve entrapment - MRI

REFERENCES

  • 1 Thompson W A, Kopell H P. Peripheral entrapment neuropathies of the upper extremity.  N Engl J Med. 1959;  260(25) 1261-1265
    CrossrefPubMedGoogle Scholar
  • 2 Chien A J, Jamadar D A, Jacobson J A, Hayes C W, Louis D S. Sonography and MR imaging of posterior interosseous nerve syndrome with surgical correlation.  AJR Am J Roentgenol. 2003;  181(1) 219-221
    PubMedGoogle Scholar
  • 3 Mondelli M, Filippou G, Gallo A, Frediani B. Diagnostic utility of ultrasonography versus nerve conduction studies in mild carpal tunnel syndrome.  Arthritis Rheum. 2008;  59(3) 357-366
    CrossrefPubMedGoogle Scholar
  • 4 Lewis A M, Layzer R, Engstrom J W, Barbaro N M, Chin C T. Magnetic resonance neurography in extraspinal sciatica.  Arch Neurol. 2006;  63 1469-1472
    CrossrefPubMedGoogle Scholar
  • 5 Polak J F, Jolesz F A, Adams D F. Magnetic resonance imaging of skeletal muscle. Prolongation of T1 and T2 subsequent to denervation.  Invest Radiol. 1988;  23(5) 365-369
    CrossrefPubMedGoogle Scholar
  • 6 Bendszus M, Koltzenberg M, Wessig C, Solymosi Sequential M R. Imaging of denervated muscle: experimental study.  AJNR Am J Neuroradiol. 2002;  23 1427-1431
    PubMedGoogle Scholar
  • 7 Wessig C, Koltzenburg M, Reiners K, Solymosi L, Bendszus M. Muscle magnetic resonance imaging of denervation and reinnervation: correlation with electrophysiology and histology.  Exp Neurol. 2004;  185(2) 254-261
    CrossrefPubMedGoogle Scholar
  • 8 Bendszus M, Koltzenburg M. Visualization of denervated muscle by gadolinium-enhanced MRI.  Neurology. 2001;  57(9) 1709-1711
    PubMedGoogle Scholar
  • 9 Küllmer K, Sievers K W, Reimers C D et al.. Changes of sonographic, magnetic resonance tomographic, electromyographic, and histopathologic findings within a 2-month period of examinations after experimental muscle denervation.  Arch Orthop Trauma Surg. 1998;  117(4–5) 228-234
    CrossrefPubMedGoogle Scholar
  • 10 Gunreben G, Bogdahn U. Real-time sonography of acute and chronic muscle denervation.  Muscle Nerve. 1991;  14(7) 654-664
    CrossrefPubMedGoogle Scholar
  • 11 Bendszus M, Wessig C, Reiners K, Bartsch A J, Solymosi L, Koltzenberg M. MR imaging in the differential diagnosis of neurogenic foot drop.  AJNR Am J Neuroradiol. 2003;  24(7) 1283-1289
    PubMedGoogle Scholar
  • 12 Cahill B R, Palmer R E. Quadrilateral space syndrome.  J Hand Surg [Am]. 1983;  8(1) 65-69
    PubMedGoogle Scholar
  • 13 McAdams T F, Dillingham M F. Surgical decompression of the quadrilateral space in overhead athletes.  Am J Sports Med. 2008;  36 528-532
    CrossrefPubMedGoogle Scholar
  • 14 McClelland D, Paxinos A. The anatomy of the quadrilateral space with reference to quadrilateral space syndrome.  J Shoulder Elbow Surg. 2008;  17(1) 162-164
    CrossrefPubMedGoogle Scholar
  • 15 Robinson P, White L M, Lax M, Salonen D, Bell R S. Quadrilateral space syndrome caused by glenoid labral cyst.  AJR Am J Roentgenol. 2000;  175(4) 1103-1105
    CrossrefPubMedGoogle Scholar
  • 16 Sofka C M, Lin J, Feinberg J, Potter H G. Teres minor denervation on routine magnetic resonance imaging of the shoulder.  Skeletal Radiol. 2004;  33(9) 514-518
    PubMedGoogle Scholar
  • 17 Wilson L, Sundaram M, Piriano D W, Ilaslan H, Recht M P. Isolated teres minor atrophy: manifestation of quadrilateral space syndrome or traction injury to the axillary nerve?.  Orthopedics. 2006;  29(5) 447-450
    PubMedGoogle Scholar
  • 18 Rokito A S, Jobe F W, Pink M M, Perry J, Brault J. Electromyographic analysis of shoulder function during the volleyball serve and spike.  J Shoulder Elbow Surg. 1998;  7(3) 256-263
    CrossrefPubMedGoogle Scholar
  • 19 Ticker J B, Djurasovic M, Strauch R J et al.. The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve.  J Shoulder Elbow Surg. 1998;  7(5) 472-478
    CrossrefPubMedGoogle Scholar
  • 20 Witvrouw E, Cools A, Lysens R et al.. Suprascapular neuropathy in volleyball players.  Br J Sports Med. 2000;  34(3) 174-180
    CrossrefPubMedGoogle Scholar
  • 21 Sandow M J, Ilic J. Suprascapular nerve rotator cuff compression syndrome in volleyball players.  J Shoulder Elbow Surg. 1998;  7(5) 516-521
    CrossrefPubMedGoogle Scholar
  • 22 Campbell W W, Landau M E. Controversial entrapment neuropathies.  Neurosurg Clin N Am. 2008;  19(4) 597-608, vi–vii
    CrossrefPubMedGoogle Scholar
  • 23 Benson E R, Schutzer S F. Posttraumatic piriformis syndrome: diagnosis and results of operative treatment.  J Bone Joint Surg Am. 1999;  81(7) 941-949
    CrossrefPubMedGoogle Scholar
  • 24 Pecina H I, Boric I, Smoljanovic T, Duvancic D, Pecina M. Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome.  Skeletal Radiol. 2008;  37(11) 1019-1023
    CrossrefPubMedGoogle Scholar
  • 25 Vieira R LR, Rosenberg Z S, Kiprovski K. MRI of the distal biceps femoris muscle: normal anatomy, variants, and association with common peroneal entrapment neuropathy.  AJR Am J Roentgenol. 2007;  189(3) 549-555
    CrossrefPubMedGoogle Scholar
  • 26 Tipton J S. Obturator neuropathy.  Curr Rev Musculoskelet Med. 2008;  1(3–4) 234-237
    CrossrefPubMedGoogle Scholar
  • 27 Bradshaw C, McCrory P, Bell S, Brukner P. Obturator nerve entrapment. A cause of groin pain in athletes.  Am J Sports Med. 1997;  25(3) 402-408
    CrossrefPubMedGoogle Scholar
  • 28 Yukata K, Arai K, Yoshizumi Y, Tamano K, Imada K, Nakaima N. Obturator neuropathy caused by an acetabular labral cyst: MRI findings.  AJR Am J Roentgenol. 2005;  184(3, suppl) S112-S114
    PubMedGoogle Scholar
  • 29 Chundru U, Liebeskind A, Seidelmann F, Fogel J, Franklin P, Beltran J. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot.  Skeletal Radiol. 2008;  37(6) 505-510
    CrossrefPubMedGoogle Scholar
  • 30 Delfaut E M, Demondion X, Bieganski A, Thiron M C, Mestdagh H, Cotten A. Imaging of foot and ankle nerve entrapment syndromes: from well-demonstrated to unfamiliar sites.  Radiographics. 2003;  23(3) 613-623
    CrossrefPubMedGoogle Scholar
  • 31 Clavert P, Lutz J C, Adam P, Wolfram-Gabel R, Liverneaux P, Kahn J L. Frohse's arcade is not the exclusive compression site of the radial nerve in its tunnel.  Rev Chir Orthop Traumatol Surg Res. 2009;  95(2) 114-118
    PubMedGoogle Scholar
  • 32 Barnum M, Mastey R D, Weiss A P, Akelman E. Radial tunnel syndrome.  Hand Clin. 1996;  12(4) 679-689
    PubMedGoogle Scholar
  • 33 Kim S, Choi J Y, Huh Y M et al.. Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity.  Eur Radiol. 2007;  17(2) 509-522
    CrossrefPubMedGoogle Scholar

Howard GallowayR B.M. B.S. 

Department of Human Movement, University of Queensland

1/27 Petersham Road, Richmond Surrey TW106UH UK

Email: galloway.howard@gmail.com

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