Traumatic neuropathies: spectrum of imaging findings and postoperative assessment

Semin Musculoskelet Radiol. 2010 Nov;14(5):512-22. doi: 10.1055/s-0030-1268071. Epub 2010 Nov 11.


Traumatic injury to peripheral nerves is a significant cause of morbidity and disability. Until reinnervation occurs, electrodiagnostic studies cannot differentiate severe axonotmetic lesions (Sunderland class 4) from complete nerve transection or neurotmesis (Sunderland class 5). This limitation is relevant clinically because in cases of neurotmesis an improved outcome may be achieved with an early surgical repair (within 1 week after trauma). High-resolution ultrasound (US) is an efficient modality to visualize injured nerves and is becoming increasingly important among radiologists and surgeons. Magnetic resonance (MR) imaging is complementary to high-resolution US, especially in evaluating deep-seated and proximal nerve segments. This article describes the imaging features of traumatic peripheral nerve lesions. The role of diagnostic imaging in stretching injuries, contusion trauma, penetrating wounds, and after surgery is discussed. A multimodality diagnostic approach including physical examination, electrophysiology, and US and MR imaging allows an accurate evaluation of most peripheral nerves. Imaging assessment of peripheral nerves trauma is useful for the diagnosis, follow-up, and postoperative evaluation.

Publication types

  • Review

MeSH terms

  • Contusions / diagnostic imaging
  • Contusions / pathology
  • Contusions / surgery
  • Humans
  • Magnetic Resonance Imaging / methods
  • Peripheral Nerve Injuries
  • Peripheral Nerves / diagnostic imaging*
  • Peripheral Nerves / pathology*
  • Peripheral Nervous System Diseases / diagnostic imaging*
  • Peripheral Nervous System Diseases / pathology*
  • Peripheral Nervous System Diseases / surgery
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / pathology*
  • Ultrasonography
  • Wounds, Penetrating / diagnostic imaging
  • Wounds, Penetrating / pathology
  • Wounds, Penetrating / surgery