Department of Human Anatomy, DIMES, Università di Genova, Largo Rosanna Benzi 8, 16138 Genoa, Italy.
Eur J Radiol. 2013 Mar;82(3):526-9. doi: 10.1016/j.ejrad.2012.09.028. Epub 2012 Dec 1.
To assess if isolated atrophy of the pronator quadratus muscle indicates anterior interosseous neuropathy on ultrasound.
IRB approval and written informed from every patient were obtained. A prospective study including 100 consecutive wrist and hand ultrasound studies in 77 patients (46 females and 31 males; 23 patients had bilateral studies) with a mean age of 45 years (range, 21-86 years) was performed between March 2010 and January 2012. The patients were chosen irrespective of age, sex, and body mass index. The studies were performed for several reasons, the most common being wrist pain (n=56), followed by ganglion cyst (n=11) and soft-tissue masses (n=10). Clinical histories, previous imaging studies and US examinations were evaluated to rule out anterior interosseous nerve neuropathy. US examinations were performed with a commercially available equipment. Pronator quadratus was checked for atrophy using flexor pollicis longus, flexor digitorum superficialis and profundus for comparison. Descriptive statistic was used.
US signs of pronator quadratus atrophy were present in 7/100 (7%) of patients. None of the patients had a bilateral atrophy of the pronator quadratus. In the patients with atrophy of the pronator quadratus, adjacent flexor muscles were normal. There was no significant difference between males and females (3 females vs 4 males) (p=0.506).
Increased reflectivity and loss in bulk of the pronator quadratus muscle does not always indicate anterior interosseous neuropathy on ultrasound.
评估单独的旋前方肌萎缩是否提示超声下的正中神经骨间前神经病变。
本研究经机构审查委员会批准，并获得每位患者的书面知情同意。2010 年 3 月至 2012 年 1 月期间，进行了一项前瞻性研究，共纳入 77 例患者（46 名女性，31 名男性；23 例患者进行了双侧研究）的 100 例连续腕关节和手部超声检查。这些患者选择时不考虑年龄、性别和体重指数。选择这些患者进行超声检查的原因主要有腕痛（n=56）、腱鞘囊肿（n=11）和软组织肿块（n=10）。对每位患者的临床病史、既往影像学检查和超声检查进行评估，以排除正中神经骨间前神经病变。使用商业超声设备进行超声检查。使用拇长屈肌、指浅屈肌和指深屈肌来检查旋前方肌萎缩。采用描述性统计学方法进行分析。
在 100 例患者中，7 例（7%）患者出现了旋前方肌萎缩的超声征象。所有患者均未出现双侧旋前方肌萎缩。在出现旋前方肌萎缩的患者中，相邻的屈肌正常。男性和女性之间无明显差异（3 名女性与 4 名男性）（p=0.506）。
超声下旋前方肌反射性增强和体积减小并不总是提示正中神经骨间前神经病变。
