Dynamic ultrasonography for assessing the nerve-fasciae relationship in entrapment syndromes

Objectives: Muscle hypertrophy is a relatively rare condition that may cause nerve entrapment syndromes. We report the case of a 14-year-old girl with unilateral hypertrophy of the abductor hallucis muscle with entrapment of the medial plantar nerve and review the literature. Methods: Computed tomography and magnetic resonance imaging revealed unilateral hypertrophy of the abductor hallucis muscle. Results: Two injections of steroid and lidocaine at the point of tenderness resulted in resolution of the pain. Conclusions: We report a rare case of hypertrophy of the abductor hallucis muscle considered with entrapment of the medial plantar nerve. Treatment of this condition should be selected according to the pathological condition of each patient.

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Entrapment Syndromes of the Ulnar Nerve

Hand and Wrist Rehabilitation ◽

10.1007/978-3-319-16318-5_14 ◽

2015 ◽

pp. 387-406

Author(s):

Grégory Mesplié ◽

Olivier Léger

Keyword(s):

Ulnar Nerve ◽

Entrapment Syndromes

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Adventitial Cystic Disease and Entrapment Syndromes Involving the Popliteal Artery

Vascular Surgery ◽

10.1201/9780203912904.ch34 ◽

2003 ◽

Author(s):

Norman Rich ◽

George Collins Jr ◽

Jerry Youkey ◽

James Salander ◽

Hugh Donohue ◽

...

Keyword(s):

Popliteal Artery ◽

Cystic Disease ◽

Adventitial Cystic Disease ◽

Entrapment Syndromes

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Modern Diagnosis and Surgical Management of Thoracic Outlet Syndrome: A Comprehensive Review

American Journal of Surgical Research and Reviews ◽

10.28933/ajsrr-2021-06-0606 ◽

2021 ◽

pp. 27

Author(s):

Keyword(s):

Upper Extremity ◽

Subclavian Vein ◽

Transverse Process ◽

Venous Hypertension ◽

Cervical Rib ◽

First Rib ◽

Extrinsic Compression ◽

Robotic Resection ◽

Entrapment Syndromes ◽

Neurogenic Tos

Conventionally TOS has been thought to represent a group of diverse disorders that result in compression of the neurovascular bundle exiting the thoracic outlet. Until recently, TOS classification has been based on symptoms, rather than the underlying pathology, with the subgroups consisting of neurogenic (NTOS), venous (VTOS or PSS), and arterial (ATOS). Neurogenic TOS accounts for over 95% of the cases, followed by venous (3–5%) and arterial (1–2%). Neurogenic TOS (NTOS) has been further divided into True NTOS (TNTOS) and Disputed NTOS (DNTOS), with DNTOS reportedly representing 95–99% of all neurogenic cases. In order to decrease confusion and to improve therapeutic results with TOS, the disease should be classified based on the underlying pathologic entity. Acquired and traumatic abnormalities of the clavicle and first rib should be classified separately. Clearly after the more common and objectively supported diagnoses of conditions that result in neurovascular symptoms of the upper extremity, such as cervical spine disease, carpal tunnel disease, and nerve entrapment syndromes, have been ruled out, there remains a group of patients who are suspected of having TOS. In these patients, rather than the more usual classification such as arterial, venous, or neurogenic, the more accurate approach from a diagnostic and therapeutic approach is to classify them as: Cervical Rib Disease: Patients with cervical rib syndrome (CRS) can have complications relating to compression of the subclavian artery (previously referred to as ATOS) and the brachial plexus(previously referred to as True NTOS) secondary to a well-formed cervical rib, or to an incompletely formed first rib, fibrous band associated with a rudimentary cervical rib, or a giant transverse process of C7. Thoracic Outlet Disease or “Subclavian Vein Compression Syndrome”: In these patients an abnormal first rib at its junction with the sternum results in compression of the subclavian vein at the subclavian-innominate junction. Compression of the vein results in venous hypertension in the upper extremity and resultant neurologic symptoms. With prolonged compression of the subclavian-innominate junction, the vein clots giving rise to Paget–Schroetter syndrome. Therefore, patients who have been previously classified as Disputed Neurogenic and Venous TOS represent a variable symptomatic presentation of the same pathologic entity, which affects the subclavian vein. Presently MRA of the thoracic outlet with arm maneuvers is the test of choice in patients suspected of having TOS. This test shows the abnormal bony tubercle on the first rib with extrinsic compression of the subclavian innominate junction, which is exacerbated with elevation of the arm above the shoulder. Robotic resection of the medial aspect of the first rib along with disarticulation of the costo-sternal joint has the best reported results to date.

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