The Role of Ultrasonography in the Diagnostic Evaluation of Patients with Polyneuropathy

Background: The role of ultrasonography (US) in the practical management of polyneuropathies, particularly axonal, remains unclear. The present study aimed to explore the contribution of the US examination of polyneuropathies in daily clinical practice. Methods: We performed a retrospective chart review of patients with clinical and electrophysiological diagnoses of polyneuropathy referred to our US laboratory over eight years. The contribution of US examination in this patient population was evaluated. Results: We analyzed 201 consecutive patients (66% men), aged 12–90 years (mean (SD), 62 (15) years). The most common referral questions were differentiation of hereditary from acquired demyelinating polyneuropathies (71 (35%) patients, sensitivity 63%, specificity 88%), and additional focal neuropathies in patients with generalized neuropathies (51 (25%) patients, sensitivity 75%, specificity 34%). The US examination was pathological in 158 (79%) of patients. The most common US finding was nerve enlargement at typical entrapment sites (73 (36%) patients), followed by proximal nerve thickening (34 (17%) patients). The US provided new diagnoses in 7 (3.5%) patients, contributed to diagnoses in 39 (19%) patients, and confirmed diagnoses in 50 (25%) patients. Conclusion: Our study demonstrated the ability of peripheral nerve US to provide useful additional diagnostic information in about half of the referred patients with polyneuropathy.