US of the Peripheral Nerves of the Lower Extremity: A Landmark Approach

Radiographics. 2016 Mar-Apr;36(2):464-78. doi: 10.1148/rg.2016150120. Epub 2016 Feb 12.

Abstract

Ultrasonography (US) is commonly used to assess the peripheral nerves of the lower extremity because of its many advantages over magnetic resonance (MR) imaging. The most obvious advantages over MR imaging are superior soft-tissue resolution, low cost, portability, lack of magnetic susceptibility artifact, and the ability to image patients who cannot undergo MR imaging. US has been shown to have equal specificity and greater sensitivity than MR imaging in the evaluation of peripheral nerves. Additional benefits are the capability of real-time and dynamic imaging, and the ability to scan an entire extremity quickly without the need for a patient to lie motionless for long periods of time, as with MR imaging. Any abnormal findings can be easily compared against the contralateral side. Published literature has shown that US has clinical utility in patients suspected of having peripheral nerve disease: US can be used to guide diagnostic and therapeutic decisions, as well as help confirm electrodiagnostic findings. Common indications for lower extremity peripheral nerve US are the evaluation for injury due to penetrating trauma, entrapment by scar tissue, or tumor. To confidently perform US of the peripheral nerves of the lower extremity, it is important to gain a thorough knowledge of anatomic landmarks and the course of each nerve. Readers who may not be familiar with US will be introduced to the basics of scanning the peripheral nerves of the lower extremity. Important anatomic landmarks and common sites of injury and entrapment will be reviewed.

Publication types

  • Review

MeSH terms

  • Femoral Nerve / diagnostic imaging
  • Humans
  • Leg / diagnostic imaging
  • Leg / innervation*
  • Magnetic Resonance Imaging
  • Morton Neuroma / diagnostic imaging
  • Peripheral Nerve Injuries / diagnostic imaging
  • Peripheral Nerves / diagnostic imaging*
  • Peripheral Nervous System Diseases / diagnostic imaging*
  • Peroneal Nerve / diagnostic imaging
  • Sciatic Nerve / diagnostic imaging
  • Tibial Nerve / diagnostic imaging
  • Ultrasonography / instrumentation
  • Ultrasonography / methods*