Karvelas Kristopher R, Walker Francis O
Department of Orthopaedic Surgery and Rehabilitation, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Front Neurol. 2019 Jun 24;10:632. doi: 10.3389/fneur.2019.00632. eCollection 2019.
Focal ulnar neuropathy at the wrist is a rare but problematic disorder often associated with the unique anatomy of this nerve as it courses through Guyon's canal, a superficial fibro-osseous tunnel in the proximal ulnar palm. The electrophysiologic features of this disorder have been well-characterized, but the sonographic anatomy of the nerve across the wrist and palm has yet to be systematically described in normal and abnormal states. In this review, we describe the basic anatomy and the sonographic appearance of the nerve in the wrist and palm in normals and individuals with pathology. The value of using US in conjunction with electrodiagnostic testing is emphasized as the two tests together provide critical information regarding etiology, predisposing factors, and functional significance. Furthermore, ultrasound is useful as a patient educational tool to promote behavioral changes that assist in nerve recovery when pathology is related to repetitive stress.
腕部局灶性尺神经病变是一种罕见但棘手的疾病，常与该神经通过Guyon管（尺侧近端手掌的一个浅表纤维骨性管道）时的独特解剖结构有关。这种疾病的电生理特征已得到充分描述，但在正常和异常状态下，该神经在腕部和手掌的超声解剖结构尚未得到系统描述。在本综述中，我们描述了正常人和有病变个体的腕部和手掌中神经的基本解剖结构和超声表现。强调了将超声与电诊断测试结合使用的价值，因为这两项测试共同提供了有关病因、易感因素和功能意义的关键信息。此外，当病变与重复性压力有关时，超声作为一种患者教育工具，有助于促进行为改变，从而协助神经恢复。
