Session Information
Session Title: AA 2021 Virtual Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Michael M. Guju, MD: No financial relationships or conflicts of interest
Case Diagnosis: CIDP
Case Description: A 71-year-old male presented to the ED with progressive bilateral upper and lower extremity weakness beginning in April 2020. Hospital evaluation in May involved MRI showing multilevel cervical/lumbar stenosis. He was diagnosed with polyradiculopathy and discharged home with therapy and plans for electrodiagnostics if weakness worsened. Patient continued to functionally decline, losing ability to ambulate within a month. Electrodiagnostics and LP were suggestive of AIDP. Plasma exchange was initiated, he improved during inpatient rehabilitation and was discharged in July. His weakness worsened one week later, and he was diagnosed with CIDP based on clinical course. PLEX was repeated and dexamethasone given with improvement. Ultrasound of the peripheral nerves were performed while inpatient. The cross sectional area (CSA) of the median, ulnar, tibial, and fibular nerves were recorded in August. The findings were compared to a study performed by Merola et al. 2016 that contrasted CSAs of peripheral nerves in CIDP patients to normal controls.
Setting: Academic HospitalAssessment/
Results: All examined nerves had statistically significantly larger CSAs than healthy controls (p < 0.001). The median, ulnar, tibial at ankle, and fibular at popliteal fossa nerve CSAs were not statistically different than the “moderately severe” CIDP group (p>0.05) The tibial nerve at popliteal fossa and sural nerve at ankle CSA were statistically significantly larger than CIDP and control groups (p < 0.001)
Discussion: This study demonstrates that ultrasound evaluation of peripheral nerves in CIPD can be achieved easily and accurately by healthcare professionals with limited experience in musculoskeletal ultrasound. Previous studies have already shown that CSA of peripheral nerves and their roots can aid in differentiating CIDP from other etiologies, but this modality is not used in clinical practice.
Conclusion: This US exam is easily reproducible and can contribute to the diagnosis of CIDP. It should be used more in practice and added to diagnostic criteria.
Level of Evidence: Level V
To cite this abstract in AMA style:
Guju MM, Alexander E, Moran A, Bagares F, Kwon S. Utility of Musculoskeletal Ultrasound in Chronic Inflammatory Demyelinating Polyneuropathy [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/utility-of-musculoskeletal-ultrasound-in-chronic-inflammatory-demyelinating-polyneuropathy/. Accessed May 21, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/utility-of-musculoskeletal-ultrasound-in-chronic-inflammatory-demyelinating-polyneuropathy/