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2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Introduction

Brachial plexopathy is a diagnostically challenging condition that requires a comprehensive evaluation, including physical examination, imaging, and Electrodiagnostic (EDx).testing. Ultrasound guidance may improve the efficiency and precision of nerve conduction studies by addressing the limitations of blind techniques, such as discomfort and inaccurate localization.

Methods

We prospectively enrolled 30 patients undergoing electrodiagnostic testing. The left upper limb was examined with ultrasound guidance (Group A), while the right upper limb underwent the blind method (Group B). The examined nerves included the median, ulnar, radial, medial and lateral antebrachial cutaneous, axillary, musculocutaneous, suprascapular, and long thoracic nerves. Stimulation duration, number of stimulation attempts, average current, and total examination time were recorded. The differences in data between the two groups were compared and analyzed.

Results

Group A demonstrated significantly lower stimulation duration (156.70±50.13 . 260.17±53.19 s), fewer stimulation attempts (17.73±3.94 . 25.80±5.23), and lower average current [32.45 (30.28, 40.13) . 42.75 (37.78,50.68) mA] compared to Group B (all P 0.001). No significant difference was observed in total examination time (387.40 ± 33.72 . 372.00 ± 47.01 s; P = 0.150).

Discussion

Ultrasound guidance improves procedural precision and reduces the need for repeated stimulations and higher electrical intensities. These benefits are achieved without extending the total examination time, making it a feasible and patient-friendly approach for routine use in clinical neurophysiology.

Conclusion

Ultrasound-guided nerve conduction studies of the brachial plexus enhance procedural efficiency and patient comfort compared to the blind method. Further large-scale studies are recommended to validate these findings and assess broader clinical applications.

© 2025 The Author(s). Published by Bentham Science Publishers.
This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2025-07-24
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References

  1. RobinsonL.R. Traumatic injury to peripheral nerves.Muscle Nerve202266666167010.1002/mus.2770636070242
     [Google Scholar]
  2. RobinsonL.R. BinhammerP. Role of electrodiagnosis in nerve transfers for focal neuropathies and brachial plexopathies.Muscle Nerve202265213714610.1002/mus.2737634331718
     [Google Scholar]
  3. MillerE.J. BhatS.G. KaneP.H. ShinA.Y. KaufmanK.R. Myoelectric performance of the reconstructed elbow flexor in patients with brachial plexus injuries.J. Electromyogr. Kinesiol.20247910294410.1016/j.jelekin.2024.10294439549619
     [Google Scholar]
  4. Wiertel-KrawczukA. Szymankiewicz-SzukałaA. HuberJ. Brachial plexus injury influences efferent transmission on more than just the symptomatic side, as verified with clinical neurophysiology methods using magnetic and electrical stimulation.Biomedicines2024127140110.3390/biomedicines1207140139061975
     [Google Scholar]
  5. EoS.J. RyuD.S. YunC.E. ParkY. WonD.S. KimJ.W. KimS.H. ParkJ.H. KimD.H. One-hand guidewire introducer kit for ultrasound-guided central venous catheterization: A proof-of-concept study.Sci. Rep.20241412922210.1038/s41598‑024‑79784‑339587166
     [Google Scholar]
  6. FainstadB. MalikM. VoigtL. The role of ultrasound in bedside procedures.Med. Clin. North Am.2025109123725210.1016/j.mcna.2024.07.00339567096
     [Google Scholar]
  7. BuntragulpoontaweeM. ChangK.V. VitoonpongT. PornjaksawanS. KitisakK. SaokaewS. KanchanasurakitS. The effectiveness and safety of commonly used injectates for ultrasound-guided hydrodissection treatment of peripheral nerve entrapment syndromes: A systematic review.Front. Pharmacol.20211162115010.3389/fphar.2020.62115033746745
     [Google Scholar]
  8. BhargavaM. GaurR. GonnadeN.M. SarankumarG. ElhenceA. GahlotN. Comparing effectiveness of 3-needle approach versus 5-needle approach of genicular nerve block on pain and quality of life in chronic osteoarthritis of knee: A double blinded randomised controlled trial.BMC Musculoskelet. Disord.202425197810.1186/s12891‑024‑07938‑539614201
     [Google Scholar]
  9. Ruiz SantiagoF. Orellana GonzálezC. Moraleda CabreraB. Láinez Ramos-BossiniA.J. Ultrasound guided procedures in the musculoskeletal system: A narrative review with illustrative examples.Quant. Imaging Med. Surg.202414118028804910.21037/qims‑24‑17639544472
     [Google Scholar]
  10. AbdelnabyR. ELgenidyA. MohamedK.A. SonbolY.T. ElwshahiM.M. ElnoutyM.M. AboutalebA.M. EbrahimM.A. DardeerK.T. HeikalH.A. GawishH.M. CartwrightM.S. Sonographic reference values of nerve size in children: A systematic review and meta‐analysis.Muscle Nerve202367321722510.1002/mus.2777336533969
     [Google Scholar]
  11. LapegueF. Faruch-BilfeldM. DemondionX. ApredoaeiC. BayolM.A. ArticoH. Chiavassa-GandoisH. RailhacJ.J. SansN. Ultrasonography of the brachial plexus, normal appearance and practical applications.Diagn. Interv. Imaging201495325927510.1016/j.diii.2014.01.02024603038
     [Google Scholar]
  12. BauteV. StrakowskiJ.A. ReynoldsJ.W. KarvelasK.R. EhlersP. BrenzyK.J. LiZ.J. CartwrightM.S. Neuromuscular ultrasound of the brachial plexus: A standardized approach.Muscle Nerve201858561862410.1002/mus.2614429672872
     [Google Scholar]
  13. Gilcrease-GarciaB.M. DeshmukhS.D. ParsonsM.S. Anatomy, imaging, and pathologic conditions of the brachial plexus.Radiographics20204061686171410.1148/rg.202020001233001787
     [Google Scholar]
  14. ShaninaE. LiaoB. SmithR.G. Brachial plexopathies: Update on treatment.Curr. Treat. Options Neurol.20192152410.1007/s11940‑019‑0562‑531030283
     [Google Scholar]
  15. TavakkolizadehA. SaifuddinA. BirchR. Imaging of adult brachial plexus traction injuries.J. Hand Surg.200126318319110.1054/jhsb.2000.055511386764
     [Google Scholar]
  16. YoshikawaT. HayashiN. YamamotoS. TajiriY. YoshiokaN. MasumotoT. MoriH. AbeO. AokiS. OhtomoK. Brachial plexus injury: Clinical manifestations, conventional imaging findings, and the latest imaging techniques.Radiographics200626Suppl. 1S133S14310.1148/rg.26si06551117050511
     [Google Scholar]
  17. ChenD.Z. CongR. ZhengM.J. ZhuT. ColesG. FengH. ZhouX.D. ZhuY.S. Differential diagnosis between pre- and postganglionic adult traumatic brachial plexus lesions by ultrasonography.Ultrasound Med. Biol.20113781196120310.1016/j.ultrasmedbio.2011.04.01521645961
     [Google Scholar]
  18. JakobsenR.L. Fuglsang-FrederiksenA. HellfritzschM.B. QeramaE. A prospective study of high resolution ultrasound in brachial plexopathies – Correlation with electrophysiological measurements.Clin. Neurophysiol.201913071144115010.1016/j.clinph.2019.03.03431096121
     [Google Scholar]
  19. MartinoliC. GandolfoN. PerezM.M. KlauserA. PalmieriF. PaduaL. TagliaficoA. Brachial plexus and nerves about the shoulder.Semin. Musculoskelet. Radiol.201014552354610.1055/s‑0030‑126807221072730
     [Google Scholar]
  20. BlandJ.D.P. Nerve conduction studies for carpal tunnel syndrome: Gold standard or unnecessary evil?Orthopedics201740419810.3928/01477447‑20170627‑0128732100
     [Google Scholar]
  21. CartwrightM.S. DemarS. GriffinL.P. BalakrishnanN. HarrisJ.M. WalkerF.O. Validity and reliability of nerve and muscle ultrasound.Muscle Nerve201347451552110.1002/mus.2362123400913
     [Google Scholar]
  22. CartwrightM.S. GriffinL.P. DowlenH. BargoilJ.M. CaressJ.B. LiZ.J. DefranzoA.J.Jr WieslerE.R. TuohyC.J. BalakrishnanN. MolnarJ.A. BauteV. KomanL.A. PoehlingG.G. WalkerF.O. A randomized trial of diagnostic ultrasound to improve outcomes in focal neuropathies.Muscle Nerve201552574675310.1002/mus.2488426296394
     [Google Scholar]
  23. CartwrightM.S. Hobson-WebbL.D. BoonA.J. AlterK.E. HuntC.H. FloresV.H. WernerR.A. ShookS.J. ThomasT.D. PrimackS.J. WalkerF.O. American Association of Neuromuscular and Electrodiagnostic Medicine Evidence‐based guideline: Neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome.Muscle Nerve201246228729310.1002/mus.2338922806381
     [Google Scholar]
  24. JorgensenS.P. CartwrightM.S. NorburyJ. Neuromuscular ultrasound.Am. J. Phys. Med. Rehabil.20221011788810.1097/PHM.000000000000179033990480
     [Google Scholar]
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Clinical Efficacy of Ultrasound Guidance in Brachial Plexus Nerve Conduction Study: A Comparative Analysis
Curr. Med. Imaging 21, E15734056377599 (2025); https://doi.org/10.2174/0115734056377599250717101905
/content/journals/cmir/10.2174/0115734056377599250717101905
/content/journals/cmir/10.2174/0115734056377599250717101905
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  • Article Type:     Research Article
Keyword(s): Brachial plexus; Clinical neurophysiology; Electrodiagnostic testing; Nerve conduction study; Procedural efficiency; Ultrasound guidance

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