TY - JOUR
T1 - Sonographic appearance of the posterior interosseous nerve at the wrist
AU - Smith, Jay
AU - Rizzo, Marco
AU - Finnoff, Jonathan T.
AU - Sayeed, Yusef A.
AU - Michaud, Johan
AU - Martinoli, Carlo
PY - 2011/9/1
Y1 - 2011/9/1
N2 - Objectives-The purpose of this study was to determine whether sonography can identify the distal posterior interosseous nerve at the wrist. Methods-On the basis of previous anatomic descriptions, high-resolution musculoskeletal sonography was used in an attempt to identify the distal posterior interosseous nerve in the wrists of 20 unembalmed cadaveric specimens (11 male and 9 female; ages 54-98 years). High-frequency scanning (17-5 MHz) of the fourth dorsal extensor compartment revealed a small (1-3 mm) hypoechoic structure located on the compartment floor, presumed to represent the posterior interosseous nerve. Electronic calipers measured the distance between Lister's tubercle and this structure, as well as the structure's radial-ulnar width and volar-dorsal height. The presumed posterior interosseous nerves of 10 specimens were then injected with diluted colored latex using sonographic guidance. Subsequent dissection definitively identified the sonographically visualized and injected structure. Results-Dissection revealed latex within the posterior interosseous nerve in all 10 injected specimens, thus confirming that the sonographically visualized structure represented the distal posterior interosseous nerve. The nerve was identified sonographically in all 20 examined specimens, was located an average of 4.88 mm (range, 2.10-10.0 mm) ulnar to Lister's tubercle, and had an average width and height of 2.35 mm (range, 1.20-3.50 mm) and 1.01 mm (range, 0.80-1.40 mm), respectively. Conclusions- High-resolution sonography can reliably identify the distal posterior interosseous nerve within the fourth dorsal extensor compartment. Clinicians should consider formal evaluation of the posterior interosseous nerve in patients presenting with dorsal wrist pain syndromes. Future investigations should explore the potential role of sonographically guided percutaneous procedures directed at the posterior interosseous nerve.
AB - Objectives-The purpose of this study was to determine whether sonography can identify the distal posterior interosseous nerve at the wrist. Methods-On the basis of previous anatomic descriptions, high-resolution musculoskeletal sonography was used in an attempt to identify the distal posterior interosseous nerve in the wrists of 20 unembalmed cadaveric specimens (11 male and 9 female; ages 54-98 years). High-frequency scanning (17-5 MHz) of the fourth dorsal extensor compartment revealed a small (1-3 mm) hypoechoic structure located on the compartment floor, presumed to represent the posterior interosseous nerve. Electronic calipers measured the distance between Lister's tubercle and this structure, as well as the structure's radial-ulnar width and volar-dorsal height. The presumed posterior interosseous nerves of 10 specimens were then injected with diluted colored latex using sonographic guidance. Subsequent dissection definitively identified the sonographically visualized and injected structure. Results-Dissection revealed latex within the posterior interosseous nerve in all 10 injected specimens, thus confirming that the sonographically visualized structure represented the distal posterior interosseous nerve. The nerve was identified sonographically in all 20 examined specimens, was located an average of 4.88 mm (range, 2.10-10.0 mm) ulnar to Lister's tubercle, and had an average width and height of 2.35 mm (range, 1.20-3.50 mm) and 1.01 mm (range, 0.80-1.40 mm), respectively. Conclusions- High-resolution sonography can reliably identify the distal posterior interosseous nerve within the fourth dorsal extensor compartment. Clinicians should consider formal evaluation of the posterior interosseous nerve in patients presenting with dorsal wrist pain syndromes. Future investigations should explore the potential role of sonographically guided percutaneous procedures directed at the posterior interosseous nerve.
KW - Arthritis
KW - Denervation
KW - Injection
KW - Nerve
KW - Posterior interosseous nerve
KW - Sonography
KW - Wrist
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U2 - 10.7863/jum.2011.30.9.1233
DO - 10.7863/jum.2011.30.9.1233
M3 - Article
C2 - 21876094
AN - SCOPUS:80052480949
SN - 0278-4297
VL - 30
SP - 1233
EP - 1239
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 9
ER -