Javvaji Anisha, Shukairy Uthman, Kashyap Anjali, Caplan Brian, Sepkowitz Eli, Endo Yoshimi, Sneag Darryl B, Nguyen Joseph T, Carroll Kaitlin M, Vad Vijay B, Lin Yenpo
Renaissance School of Medicine, Stony Brook, New York, USA.
Weill Cornell Medicine, New York, New York, USA.
Orthop J Sports Med. 2025 Aug 5;13(8):23259671251358397. doi: 10.1177/23259671251358397. eCollection 2025 Aug.
Lateral elbow pain affects 1% to 3% of the general population. Neuropathy involving the posterior interosseous nerve (PIN) is a potential cause of lateral elbow pain but shares overlapping symptoms with other pathologies, particularly lateral epicondylitis, which may be difficult to distinguish based solely on patient history, physical examination, or electrodiagnostic testing (EDX). Conventional magnetic resonance imaging may reveal denervation edema or atrophy in PIN-innervated muscles, but abnormal signal intensity within the nerve may not be apparent.
By incorporating magnetic resonance neurography (MRN) as a diagnostic tool, physicians may be able to identify peripheral nerve pathologies and differentiate PIN neuropathy from other conditions.
Cross-sectional study; Level of evidence, 3.
The authors conducted an institutional review board-approved retrospective study to evaluate MRN findings of patients with clinically suspected PIN neuropathy. Patients were initially identified via a radiology report database. Patients with previous elbow surgery or trauma and those with EDX-confirmed Parsonage-Turner syndrome were excluded. The cohort was age-matched and compared with a control group of patients with clinically suspected cubital tunnel syndrome. Two radiologists, blinded to patient symptoms, graded the MRN examinations focusing on peripheral nerves, muscles, and extensor tendon pathology. Independent-samples tests and chi-square tests were used to compare means and proportions, respectively, between the 2 cohorts.
The final cohort consisted of 47 patients with suspected PIN neuropathy and 47 control patients. No significant demographic differences were found between the groups. Statistically significant findings in the study cohort compared with the control group included abnormal T2-weighted hyperintensity of the PIN-innervated extensor muscles ( = .0052), and the PIN ( = .0002), as well as enlargement of both the PIN ( < .0001), and the radial nerve proper ( = .0410).
This study found that MRN can identify imaging characteristics indicative of PIN involvement compared with the control group. Future studies should focus on determining the prognostic value of these MRN findings for nonsurgical versus surgical intervention.
外侧肘部疼痛影响1%至3%的普通人群。累及骨间后神经（PIN）的神经病变是外侧肘部疼痛的一个潜在原因，但与其他病症有重叠症状，尤其是外侧上髁炎，仅根据患者病史、体格检查或电诊断测试（EDX）可能难以区分。传统磁共振成像可能显示PIN支配肌肉的失神经水肿或萎缩，但神经内的异常信号强度可能不明显。
通过将磁共振神经造影（MRN）作为一种诊断工具，医生或许能够识别周围神经病变，并将PIN神经病变与其他病症区分开来。
横断面研究；证据等级，3级。
作者进行了一项经机构审查委员会批准的回顾性研究，以评估临床疑似PIN神经病变患者的MRN检查结果。患者最初通过放射学报告数据库进行识别。排除既往有肘部手术或创伤史的患者以及EDX确诊的Parsonage-Turner综合征患者。该队列进行年龄匹配，并与临床疑似肘管综合征的对照组患者进行比较。两名对患者症状不知情的放射科医生对MRN检查进行评分，重点关注周围神经、肌肉和伸肌腱病变。分别使用独立样本t检验和卡方检验比较两组之间的均值和比例。
最终队列包括47例疑似PIN神经病变患者和47例对照患者。两组之间未发现显著的人口统计学差异。与对照组相比，研究队列中的统计学显著发现包括PIN支配的伸肌在T2加权像上出现异常高信号（P = 0.0052），以及PIN本身（P = 0.0002），同时PIN（P < 0.0001）和桡神经主干（P = 0.0410）均增粗。
本研究发现，与对照组相比，MRN能够识别出表明PIN受累的影像学特征。未来的研究应侧重于确定这些MRN检查结果对于非手术与手术干预的预后价值。
