Ultrasound is a painless procedure without complications and major contraindications. We specialize in peripheral nerves, but we also look at surrounding tissue. In many cases we are able to examine the nerve along its entire length and to determine the location and cause of nerve damage. This is a very important procedure that complements the doctor’s examination. The ultrasound of nerves currently has a fundamental position next to electromyography (EMG) and magnetic resonance imaging (MRI). In many cases, it can answer the question of the cause of the nerve damage most accurately.
Using ultrasound we can see the shape, size, course and other properties of the nerve and its surroundings. This method allows us to find out, for example, whether and where the nerve is compressed, if there is a nerve tumor or if there is inflammation of the surrounding structures. We can also detect various anomalies of the nerve and vascular supply around the nerve. Knowledge of these abnormalities could be very important during any necessary surgery.
The duration of the ultrasound examination is approximately 30 minutes. The examination is painless and very well tolerated. Contraindications (the patient’s medical condition that does not allow this examination) practically do not exist. Before the ultrasound, we briefly examine the patient clinically and ask about their medical history. The total duration of the examination (including ultrasound) is approximately 60 minutes. A ultrasound examination is suggested by your primary care doctor – usually neurologist, general practitioner, orthopedist, etc. It is advisable for patients to have a specific question about their problem so that our doctor can focus on your issue.
Which nerves do we normally examine? On the upper limb the median nerve, ulnar nerve, radial nerve, musculocutaneous, cutaneous antebrachii medialis and some other smaller nerves can be well seen. For example, we can find damage to these nerves in various pain syndromes of the upper limbs. For example, we can diagnose the carpal tunnel syndrome (this is the most common mononeuropathy = involvement of a single nerve), neuropathy of the ulnar nerve in the elbow (the second most common mononeuropathy), damage of the radial nerve after bone fractures. The brachial plexus can also be examined. On the lower limb, we can see partly the peroneal (fibular) nerve, lateral cutaneous nerve, sciatic nerve, tibial nerve (for example in the tarsal tunnel syndrome), sural nerve and other nerves in the areas available to ultrasound. The involvement of the first two mentioned nerves is again very common. If it is within the possibilities of ultrasound, it is possible to examine other areas as well.
The importance of nerve ultrasound in the Czech Republic has been growing rapidly in recent years, in Western and Northern Europe and North America as well. It is often a common examination in large cities. Our activities are also focused on teaching doctors in this area of the Czech and Slovak Republics. We organize educational courses and conferences in cooperation with St. Anne´s University Hospital Brno. We were the first to organize a national Czech conference. We also participate in the review of foreign or Czech publications concerning nerve ultrasound. We also continuously educate ourselves in this area – we regularly participate in various educational courses and conferences abroad and in the Czech Republic. We have repeatedly completed internships in European hospitals with leading experts in this field. We are thus among the most experienced in the Czech Republic.
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Eduard Minks, MD, PhD
Alexandra Minksová, MD