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Muscle Nerve. 2018 Sep;58(3):359-366. doi: 10.1002/mus.26108. Epub 2018 Mar 25.

Brachial plexitis or neuritis? MRI features of lesion distribution in Parsonage-Turner syndrome.

Author information

1
Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, New York, New York, 10021, USA.
2
College of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.
3
Department of Orthopedic Surgery, Hand, and Upper Extremity, Hospital for Special Surgery, New York, New York, USA.
4
Department of Physiatry, Sports Medicine, Hospital for Special Surgery, New York, New York, USA.

Abstract

INTRODUCTION:

This study seeks to characterize lesion distribution in Parsonage-Turner Syndrome (PTS) using high-resolution MRI.

METHODS:

MRIs of 27 patients with clinically confirmed PTS were reviewed. Two radiologists independently evaluated the brachial plexus proper, side and terminal plexus branches, and more distal, upper extremity nerves.

RESULTS:

All patients had at least 1 clinically involved nerve. MRI revealed that the plexus appeared normal in 24 of 27 patients; in 3 other patients, signal hyperintensity was seen immediately proximal to the take-off of abnormal side or terminal branch nerves. Focal intrinsic constrictions were detected in 32 of 38 nerves. MRI interobserver agreement was high (Cohen's κ = 0.839).

DISCUSSION:

MRI findings, corroborated by electrodiagnostic testing, localized abnormalities to plexus branches and peripheral nerves, suggesting that PTS is characterized by 1 or more mononeuropathies rather than changes involving a portion of or the complete plexus proper. These results may improve diagnosis, prognostication, and management. Muscle Nerve 58: 359-366, 2018.

KEYWORDS:

Parsonage-Turner syndrome; brachial neuritis; brachial plexitis; hourglass constrictions; mononeuropathy multiplex; neuralgic amyotrophy

PMID:
29461642
DOI:
10.1002/mus.26108
[Indexed for MEDLINE]

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