"Small but mighty" - A radiologists' primer for ultrasound imaging of the smaller peripheral nerves.

Agarwal, Aakanksha; Chandra, Abhishek; Shirodkar, Kapil; Shah, Ankit; Murray, Timothy E; Iyengar, Karthikeyan P; Prakash, Mahesh; Botchu, Rajesh · Skeletal Radiol · 2025

review · Level V

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Abstract

Peripheral nerve imaging is a powerful tool in evaluating peripheral neuropathy. This review aims to provide an overview of the anatomy, clinical significance and pathologies of small peripheral nerves, typically less than 2 mm in diameter. High frequency ultrasound probes offer the best assessment of these nerves whilst permitting real-time clinical correlation, while the role of MRI is inherently limited by spatial resolution constraints and the lack of patient contact. This review discusses techniques for sonographic identification, strategies for optimal visualization and common ultrasound-guided procedures.

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