Park Hong Bum, Ryou Chae Hyeon, Kim Ki Hoon, Kim Dong Hwee
Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Ansan Hospital, Ansan, Korea.
J Clin Neurol. 2023 Jul;19(4):376-380. doi: 10.3988/jcn.2022.0206.
Investigating the supinator muscle (SUP) is important for diagnosing radial neuropathy or cervical radiculopathy in needle electromyography (EMG). However, different authors have proposed several locations for needle EMG placement in the SUP. This study aimed to determine the optimal needle insertion position for examining the SUP via needle EMG under ultrasonographic guidance.
This study included 16 male (32 upper limbs) and 15 females (30 upper limbs). In the supine position, the line connecting the midpoint of the dorsal wrist to the upper margin of the radial head (RH) (RH_WRIST line) was measured while the forearm was pronated. Under ultrasonographic guidance, the thickness of the SUP was measured at 1-cm intervals from the RH to 4 cm along the RH_WRIST line. Moreover, the horizontal distance (HD) from the RH_WRIST line to the posterior interosseous nerve (PIN) and the distance from the RH to the point where the RH_WRIST line and the PIN intersected (VD_PIN_CROSS) were measured.
VD_PIN_CROSS was 51.25±7.0 mm (mean±SD). The muscle was the thickest at 3 cm (5.6±0.8 mm) and 4 cm (5.4±1.0 mm) from the RH. The distances from the PIN to these points were 14.1±3.9 mm and 9.0±4.3 mm, respectively.
Our findings suggest that the optimal needle placement is at 3 cm from the RH.
在针极肌电图（EMG）检查中，对旋后肌（SUP）进行检测对于诊断桡神经病变或颈椎病神经根病很重要。然而，不同作者提出了针极EMG在旋后肌中的几个不同进针位置。本研究旨在确定在超声引导下通过针极EMG检查旋后肌的最佳进针位置。
本研究纳入了16名男性（32条上肢）和15名女性（30条上肢）。受试者仰卧位，前臂旋前时测量腕背中点与桡骨头（RH）上缘连线（RH_WRIST线）。在超声引导下，沿着RH_WRIST线从桡骨头开始每隔1 cm测量旋后肌厚度。此外，测量从RH_WRIST线到骨间后神经（PIN）的水平距离（HD）以及从桡骨头到RH_WRIST线与PIN交点的距离（VD_PIN_CROSS）。
VD_PIN_CROSS为51.25±7.0 mm（均值±标准差）。在距桡骨头3 cm（5.6±0.8 mm）和4 cm（5.4±1.0 mm）处肌肉最厚。从PIN到这些点的距离分别为14.1±3.9 mm和9.0±4.3 mm。
我们的研究结果表明，最佳进针位置是距桡骨头3 cm处。
