Limits...
Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications.

Chhabra A, Ahlawat S, Belzberg A, Andreseik G - Indian J Radiol Imaging (2014)

Bottom Line: The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment.While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene.With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, Baltimore, MD, USA.

ABSTRACT
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.

No MeSH data available.


Related in: MedlinePlus

Moderate stretch injury (Sunderland grade II/III). A 42 year old man with right clavicle fracture status post internal fixation developed right shoulder pain and substantial right arm weakness. Electromyography (EMG) raised the suspicion of radiculopathy versus plexopathy. Clinically, nerve avulsion could not be excluded. MIP reconstruction from coronal 3D STIR SPACE (A) shows moderate diffuse enlargement of the right brachial plexus with abnormal hyperintensity and no neuroma or discontinuity. Sagittal STIR (B) image demonstrates mild diffuse enlargement of median (small arrow), ulnar (medium arrow), and radial (large arrow) nerves. Notice subtle denervation edema-like signal of the infraspinatus muscle (double arrows). The patient improved over next 6 months consistent with the diagnosis of Sunderland grade II/III injury
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4126136&req=5

Figure 5: Moderate stretch injury (Sunderland grade II/III). A 42 year old man with right clavicle fracture status post internal fixation developed right shoulder pain and substantial right arm weakness. Electromyography (EMG) raised the suspicion of radiculopathy versus plexopathy. Clinically, nerve avulsion could not be excluded. MIP reconstruction from coronal 3D STIR SPACE (A) shows moderate diffuse enlargement of the right brachial plexus with abnormal hyperintensity and no neuroma or discontinuity. Sagittal STIR (B) image demonstrates mild diffuse enlargement of median (small arrow), ulnar (medium arrow), and radial (large arrow) nerves. Notice subtle denervation edema-like signal of the infraspinatus muscle (double arrows). The patient improved over next 6 months consistent with the diagnosis of Sunderland grade II/III injury


Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications.

Chhabra A, Ahlawat S, Belzberg A, Andreseik G - Indian J Radiol Imaging (2014)

Moderate stretch injury (Sunderland grade II/III). A 42 year old man with right clavicle fracture status post internal fixation developed right shoulder pain and substantial right arm weakness. Electromyography (EMG) raised the suspicion of radiculopathy versus plexopathy. Clinically, nerve avulsion could not be excluded. MIP reconstruction from coronal 3D STIR SPACE (A) shows moderate diffuse enlargement of the right brachial plexus with abnormal hyperintensity and no neuroma or discontinuity. Sagittal STIR (B) image demonstrates mild diffuse enlargement of median (small arrow), ulnar (medium arrow), and radial (large arrow) nerves. Notice subtle denervation edema-like signal of the infraspinatus muscle (double arrows). The patient improved over next 6 months consistent with the diagnosis of Sunderland grade II/III injury
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126136&req=5

Figure 5: Moderate stretch injury (Sunderland grade II/III). A 42 year old man with right clavicle fracture status post internal fixation developed right shoulder pain and substantial right arm weakness. Electromyography (EMG) raised the suspicion of radiculopathy versus plexopathy. Clinically, nerve avulsion could not be excluded. MIP reconstruction from coronal 3D STIR SPACE (A) shows moderate diffuse enlargement of the right brachial plexus with abnormal hyperintensity and no neuroma or discontinuity. Sagittal STIR (B) image demonstrates mild diffuse enlargement of median (small arrow), ulnar (medium arrow), and radial (large arrow) nerves. Notice subtle denervation edema-like signal of the infraspinatus muscle (double arrows). The patient improved over next 6 months consistent with the diagnosis of Sunderland grade II/III injury
Bottom Line: The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment.While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene.With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, Baltimore, MD, USA.

ABSTRACT
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.

No MeSH data available.


Related in: MedlinePlus