Raed Gasemaltayeb1, Thapat Wannarong2, Hemani Ticku1, David Preston1
1University Hospitals - Cleveland Medical Center, 2Duke University Hospital
Objective:
To study the effectiveness of NMUS in the diagnosis, management and outcomes in patients with neuromuscular disorders.
Background:
Neuromuscular ultrasound (NMUS) is increasingly being used in the evaluation of many neuromuscular conditions. It has potential advantages being inexpensive, noninvasive, and portable, and able to discern structural anatomic information not possible by clinical exam or traditional electrodiagnostic studies (EDX). However, more information about how best it should be incorporated in the routine evaluation of neuromuscular patients and the degree to which it influences subsequent management and outcomes are needed.
Design/Methods:
A retrospective cohort study was performed of all patients referred for NMUS to a single tertiary university laboratory during 2021. Demographic information, referral diagnoses and clinical information were analyzed along with findings on NMUS. For patients who also had EDX studies, their results were compared with findings on NMUS. For all cases, determination was made whether NMUS did or did not aid in the diagnosis; confirmed the diagnosis made clinically and/or by EDX but did not change management; added important information, and/or made a decisive impact on subsequent management.
Results:
A total of 502 patients were analyzed who were referred for variety of diagnoses, most frequently mononeuropathies, brachial plexopathy and polyneuropathy. Abnormal NMUS findings were found in 81.7%. Of the abnormal patients, NMUS added additional useful information in 79%, and was decisive in management in 62.7% of cases.
Conclusions:
NMUS is an effective diagnostic tool that frequently adds key structural information which is otherwise not obtainable via clinical and EDX evaluation. In the majority of referred patients NMUS was found to be decisive in guiding further management and affecting outcomes.