Updates in diagnostic tools for diagnosing nerve injury and compressions.

J Hand Surg Eur Vol · Jun 2024 · Review

Bourke G, Wade RG, van Alfen N

Leeds Institute for Medical Research, University of Leeds, Leeds, UK

Hand & Upper Extremity

SUMMARY — THE REDUCTIONMultimodal assessment combining clinical evaluation, electrodiagnostics, ultrasound, and MR neurography improves preoperative understanding of nerve injury severity and predicts functional recovery better than any single modality.
Abstract, as published

Predicting prognosis after nerve injury and compression can be challenging, even for the experienced clinician. Although thorough clinical assessment can aid diagnosis, we cannot always be precise about long-term functional recovery of either motor or sensory nerves. To evaluate the severity of nerve injury, surgical exploration remains the gold standard, particularly after iatrogenic injury and major nerve injury from trauma, such as brachial plexus injury. Recently, advances in imaging techniques (ultrasound, magnetic resonance imaging [MRI] and MR neurography) along with multimodality assessment, including electrodiagnostic testing, have allowed us to have a better preoperative understanding of nerve continuity and prediction of nerve health and possible recovery. This article outlines the current and potential roles for clinical assessment, exploratory surgery, electrodiagnostic testing ultrasound and MRI in entrapment neuropathies, inflammatory neuritis and trauma. Emphasis is placed on those modalities that are improving in diagnostic accuracy of nerve assessment before any surgical intervention.

Featured in the 2026-07-08 issue.

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