Ultrasound of the brachial plexus
Is a non-invasive method for the study of the peripheral nervous system, which is designed to identify diseases and traumatic injuries. This procedure is mandatory for those patients who have disorders of the nervous system in the upper limb. Very often, this pathological condition may be due to previously suffering a shoulder injury, e.g. dislocation or fracture.
The brachial plexus consists of several nerve fibers coming from the cervical and thoracic spine. In total, there are three zones, each of which must be carefully investigated for obtaining informative conclusions about the condition of the brachial plexus.
Ultrasound examination of nerves of the brachial plexus is based on detection of some anatomic landmarks in the neck which are bones (roots), muscles (trunks) and vessels (divisions and cords). After exiting the neural foramina, the roots pass between the anterior and posterior tubercles of the transverse processes of the cervical vertebrae, in close relationship with the vertebral artery and vein.
Parameters defined during the test
- The thickness of the plexus nerve trunks.
- The contours of nerves.
- Cross-section condition.
- Structure of nerve fibers.
- The presence of pathological lesions.
- Relationship of nerves to the surrounding organs and tissues.
- Impaired motor activity of the upper limb.
- Disorders of sensation over the entire surface of hands.
- Horner syndrome: a persistently small pupil (miosis), a notable difference in pupil size between the two eyes (anisocoria), little or delayed opening (dilation) of the affected pupil in dim light, drooping of the upper eyelid (ptosis), slight elevation of the lower lid, sometimes called upside-down ptosis, little or no sweating (anhidrosis) either on the entire side of the face or an isolated patch of skin on the affected side
Ultrasound of the brachial plexus requires no special preparation. The procedure is performed in the supine position of the patient. If the ultrasound is held against the open injury of the subclavian region, the sensor is wrapped so protects the patient from infection, without distorting the results of the study.
- Post-traumatic brachial plexopathies.
- Primary tumors (benign and malignant).
- Secondary tumors
- Post irradiation injuries.
- Inflammatory plexitis.