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AIUM Endowment for Education and Research Awards Grant
February 18, 2015
Congratulations to Ogonna Kenechi Nwawka, MD, musculoskeletal imaging fellow, Hospital for Special Surgery, and clinical fellow of radiology, Weill Medical College of Cornell University, for being the recipient of an
AIUM Endowment for Education and Research
grant, supported in part by a generous unrestricted educational grant from Philips Healthcare.
Dr Nwawka's project is entitled "Clinical Effectiveness of Ultrasound Versus Magnetic Resonance Imaging for the Diagnosis of Brachial Plexopathy and Upper Extremity Peripheral Neuropathy, With Clinical, Surgical and Histologic Correlation".
Brachial plexopathy and upper extremity peripheral neuropathy often produce debilitating symptoms including upper extremity pain, weakness and muscle atrophy, leading to severe limitations to activities of daily living. Clinicians must use a multidisciplinary approach to treatment, which depends upon the causative factors. Currently, magnetic resonance imaging (MRI) is the modality of choice for the imaging evaluation of brachial plexopathy and upper extremity peripheral neuropathy and is used in the detection of both traumatic and non-traumatic lesions. Conditions including traumatic brachial plexus injury, inflammatory and radiation plexitis, thoracic outlet syndrome and neuroma and tumor involvement are well-evaluated on MRI. With advancements in technology, high frequency ultrasound (US) transducers have the ability to produce superior, high resolution images, allowing for high quality US imaging evaluation of ligaments, tendons and muscles, and superb depiction of nerve fascicular anatomy. However, the diagnosis of neural pathology on US is not currently widespread, as evaluation is user dependent and clinicians are uncertain of its accuracy. The benefits of US over MR neurography in the diagnosis of brachial plexopathy and upper extremity peripheral neuropathy lay in the ability of high frequency transducers to evaluate the fascicular anatomy of the nerve over a long segment, the ability to reproduce symptomatology by dynamic compression, and to readily image the contralateral side for comparison. These advantages are in addition to the increased availability and lower cost of ultrasound as compared to MRI, and the virtual absence of contraindications to US imaging. This study aims to validate the use of US in the diagnosis of brachial plexopathy and upper extremity peripheral neuropathy by comparing to MRI as well as histology, surgery and clinical findings.