Comprehensive assessment of ultrasound capabilities in diagnosing upper limb tunnel neuropathies

Abstract. Introduction. Upper extremity tunnel neuropathies are a common cause of pain syndrome and functional impairments in patients of various ages, requiring a comprehensive diagnostic approach using modern imaging techniques. Due to its accessibility, safety, and high information content, ultrasound examination allows an accurate assessment of soft tissue structures and the degree of nerve compression. The aim of this study was to comprehensively 8 ВЕСТНИК СОВРЕМЕННОЙ КЛИНИЧЕСКОЙ МЕДИЦИНЫ 2025 Том 18, вып. 2ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ investigate the diagnostic value of ultrasound examination in upper extremity tunnel neuropathies, as well as to evaluate the ultrasound examination efficiency for detecting the nerve compression degree and for dynamically monitoring patients’ conditions. Materials and Methods. The study was conducted at the National Medical Center from January, 2023 to December, 2024. It included 50 patients (28 men and 22 women) aged 25 to 65 years with clinical manifestations of upper extremity tunnel neuropathies (numbness, paresthesia, decreased muscle strength, and pain). Inclusion criteria were the presence of a confirmed nerve compression syndrome and the absence of any acute inflammatory diseases. Patients underwent a comprehensive examination, including medical history collection, physical examination, electromyography, magnetic resonance imaging, and ultrasound examination of the upper extremity nerves. Ultrasound examination was performed using a high-frequency linear transducer (7–15 MHz), with assessment of nerve thickness in the compression zone and proximally, echogenicity, edema, and nerve mobility. Increase in the nerve transverse diameter by more than 20% compared to the proximal segment was considered a diagnostically significant finding. Comparison was made with electromyography and magnetic resonance imaging data, assessing amplitude, nerve conduction velocity, and the condition of surrounding tissues. Statistical analysis was performed in SPSS 25.0 using Student’s t-test, with a significance level of p<0.05. Results and Discussion. Patients were divided into two groups: One with carpal tunnel syndrome (n=30) and one with cubital tunnel syndrome (n=20). A comprehensive examination included ultrasound examination, Doppler sonography, and magnetic resonance imaging, which revealed nerve thickening, decreased echogenicity and blood flow, and changes in structure on T2-weighted images. Electromyography showed a decrease in nerve conduction velocity, correlating with nerve thickening and decreased blood flow, which confirms the importance of a comprehensive approach to diagnosing tunnel neuropathies. Conclusions. A comprehensive approach to the diagnosis of upper extremity tunnel neuropathies using ultrasound examination, Doppler sonography, and magnetic resonance imaging provides high accuracy in assessing nerve compression, vascular components, and structural changes. The findings confirm the importance of combining these methods to optimize diagnostics and stratify patients