Volume 48, Issue 2 pp. 171-178
Research Article

Diagnostic value of high-resolution sonography in common fibular neuropathy at the fibular head

Leo H. Visser MD, PhD

Corresponding Author

Leo H. Visser MD, PhD

Department of Neurology and Clinical Neurophysiology, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands

Correspondence to: L.H. Visser; e-mail: [email protected]Search for more papers by this author
Vanessa Hens

Vanessa Hens

Department of Neurology and Clinical Neurophysiology, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands

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Maud Soethout

Maud Soethout

Department of Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, The Netherlands

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Violene De Deugd-Maria

Violene De Deugd-Maria

Department of Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, The Netherlands

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Jacqueline Pijnenburg

Jacqueline Pijnenburg

Department of Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, The Netherlands

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Geert J.F. Brekelmans MD, PhD

Geert J.F. Brekelmans MD, PhD

Department of Neurology and Clinical Neurophysiology, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands

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First published: 18 November 2012
Citations: 64

ABSTRACT

Introduction

In 30% of patients with common fibular (CF) neuropathy at the fibular head, reliable localization of the site of the lesion by means of electrodiagnostic testing is challenging.

Methods

We prospectively assessed proximal CF nerve cross-sectional area (CSA) measurements and at the fibular head in 87 patients with CF neuropathy and 16 with a different condition. Reference values were obtained in 64 healthy volunteers.

Results

Patients with CF neuropathy had a significantly larger CF nerve CSA than controls and patient controls (P < 0.0001). Sonography localized the lesion at the fibular head in 55% and just above it in 71% of patients. Assessment of the most thickened part of the CF nerve resulted in a cut-off value of >8 mm2 with a sensitivity of 90% (CI 81–95%) and a specificity of 69% (CI 58–78%).

Conclusion

High-resolution sonography in addition to electrodiagnostic testing improves diagnostic reliability in CF neuropathy. Muscle Nerve, 48: 171–178, 2013

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