The role of high-resolution ultrasound in the diagnosis of a traumatic neuroma in an injured median nerve.

Abstract

Since the development of high-resolution ultrasound, its role in the diagnosis of peripheral nerve lesions has steadily increased. We present the case of a 42-yr-old woman who experienced consistent numbness over the left hand and fingers after cutting the wrist in a suicide attempt and subsequent tendon and median nerve repair and a period of rehabilitation. Electrodiagnostic testing was normal, but high-resolution ultrasound demonstrated hypoechoic, focal swelling in the region of the median nerve consistent with a neuroma. Neuroma was confirmed at surgery, and after excision of the neuroma, nerve repair with a nerve graft was performed. Postoperatively, the patient's symptoms improved significantly. This case suggests that high-resolution ultrasound may be superior to electrodiagnostic studies for the diagnosis of traumatic neuroma.