Role of high-resolution ultrasound in assessment of iatrogenic sciatic nerve injury in pediatric age group in correlation with electrophysiological studies.

Abadir, Mary Samir Samuel; Arafa, Hanan Mahmoud Hussein; El Molla, Soad Said Ahmed; Gamal El Deen, Noha Mohamed

doi:10.21608/asmj.2024.269960.1222

Role of high-resolution ultrasound in assessment of iatrogenic sciatic nerve injury in pediatric age group in correlation with electrophysiological studies.

Document Type : Original Article

Authors

¹ Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

² Department of Rheumatology, Physical Medicine & Rehabilitation, National Institute of Neuro-Motor System, Giza, Egypt.

10.21608/asmj.2024.269960.1222

Abstract

Background: The sciatic nerve is among the largest peripheral nerves in terms of thickness within the body. Injecting the gluteal muscles can lead to an iatrogenic issue known as sciatic nerve injury, which can result in notable health complications. It may lead to different symptoms from mild paresthesia to serious neurologic sequel. Aim of the work: To clarify the role of ultrasound (US) in the assessment of the sciatic nerve injury in correlation of electrophysiological studies. Material and methods: This study was performed prospectively including 40 children complaining of unilateral limping or paresthesia of lower limbs with history of intramuscular injection in the buttocks. These patients were examined by ultrasound (US) and Nerve conduction studies (NCS) for their lower limbs. All US covered the whole length of sciatic nerve and muscles from the popliteal fossa up to the greater sciatic notch. The nerve was examined as regards the contour, architecture (fascicular pattern), caliber and integrity of the injured sciatic nerve segment as well as the measurement of cross-sectional area (CSA) in maximum diameter. On the other hand, the muscles (peroneus muscles, calf muscles and posterior thigh muscles) were examined as regards fatty infiltration and decreased circumference. NCS were performed for tibial and common peroneal nerves. All concerned studies were recorded for the affected limb and compared to the contralateral normal limb. Results: US confirmed the clinical diagnosis of sciatic nerve injury in all included patients; while, NCS confirmed the clinical diagnosis of sciatic nerve injury in only 71% of the included patients. There was no correlation between the electrophysiological findings and dynamic US findings. Conclusion: US can be utilized as the initial imaging of choice for the evaluation of iatrogenic sciatic nerve injury especially in acute phase when nerve conduction can't be done.

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