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The Use of Ultra High-frequency Ultrasound to Identify a Focal Saphenous Neuropathy: A Case Report

Austin M. B. Grant, MD (Ohio State University Hospital PM&R Program, Hilliard, OH, United States); Jeffrey Strakowski, MD

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Friday, November 15, 2019

Session Title: Musculoskeletal and Sports Medicine Case Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 3

Disclosures: Austin M. B. Grant, MD: Nothing to disclose

Case Description: The patient presented with numbness of the medial right foot 3 weeks after surgical fixation of a right fibular fracture. His surgery was complicated by a 4cm by 4cm burn anterior to the medial malleolus caused by accidental activation of an electrocautery device. He had decreased sensation in a well-circumscribed area at and distal to the burn site.

Setting: Outpatient PM&R Clinic

Patient: 18-year-old male with pain and sensory disturbance in the right foot.

Assessment/Results: Ultra high-frequency (UHF) ultrasound was utilized to visualize the details of the injury to the distal branch of the saphenous nerve. Transducers with upper limit frequencies of 48 MHz and 70 MHz were utilized. The extremely high resolution revealed the burn injury and nature of the scar tissue surrounding the nerve.

Discussion: UHF ultrasound is defined as frequencies greater than 24 MHz. This represents a newer innovation in ultrasound technology that provides unprecedented resolution of superficial structures. Focal injuries of smaller nerves can result in considerable morbidity and can be challenging to reliably assess with conventional imaging and electrophysiology. UFH ultrasound helped define a challenging neuropathy in this case and assisted with prognosis and identifying a potential treatment plan.

Conclusion: UHF ultrasound is a newer innovation in imaging that has the potential for providing useful diagnostic information in focal neuropathies of smaller nerves.

Level of Evidence: Level V

To cite this abstract in AMA style:

Grant AMB, Strakowski J. The Use of Ultra High-frequency Ultrasound to Identify a Focal Saphenous Neuropathy: A Case Report [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/the-use-of-ultra-high-frequency-ultrasound-to-identify-a-focal-saphenous-neuropathy-a-case-report/. Accessed May 15, 2025.
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