@article{103784,
  keywords = {leprosy, nerve ultrasound, Vasculitic neuropathy},
  author = {Hu N and Niu J and Chen L and Qian M and Liu M},
  title = {High-Resolution Ultrasound for Differentiation Between Leprosy-Associated Neuropathy and Vasculitic Peripheral Neuropathy: A Pilot Study.},
  abstract = {<p><strong>INTRODUCTION/AIMS: </strong></p>

<p>Leprosy-associated neuropathy and vasculitic neuropathy (VN) share overlapping clinical features, making differentiation challenging in nonendemic regions. High-resolution ultrasound may aid in distinguishing these conditions, but comparative data are limited. This pilot study aimed to characterize and compare ultrasound findings in biopsy-confirmed leprosy-associated neuropathy and VN, and to identify distinctive sonographic features for early differential diagnosis.</p>

<p><strong>METHODS: </strong></p>

<p>We retrospectively included 12 patients with biopsy-confirmed neuropathy (3 leprosy-associated, 6 systemic VN, 3 nonsystemic VN) from a prospectively maintained database at Peking Union Medical College Hospital (2020-2025). All had undergone standardized clinical assessments, nerve conduction studies, and high-resolution ultrasound of median, ulnar, tibial, fibular, and sural nerves, cervical roots, and brachial plexus. Cross-sectional areas (CSA) were measured at predetermined sites. Power Doppler assessed intraneural vascularization in enlarged segments.</p>

<p><strong>RESULTS: </strong></p>

<p>In leprosy patients, nerve enlargement predominated proximal to entrapment sites (carpal tunnel, cubital tunnel/above-elbow, fibular head), with moderate-to-marked CSA increases. Intraneural power Doppler signals were detected in all enlarged segments (12/12, 100%). In VN patients, enlargement was mild-to-moderate, predominantly in nonentrapment regions (mid-forearm, upper arm), with less frequent vascularization (SVN: 25.0%; NSVN: 83.3%). Brachial plexus/cervical root enlargement was uncommon in both groups. Lower limb nerve enlargement occurred exclusively in leprosy.</p>

<p><strong>DISCUSSION: </strong></p>

<p>Distinct ultrasound patterns may help distinguish leprosy-associated neuropathy from VN. Marked enlargement near entrapment sites with increased vascularization was more commonly observed in leprosy, while mild nonentrapment enlargement was more frequent in VN.</p>
},
  year = {2026},
  journal = {Muscle & nerve},
  month = {07/2026},
  issn = {1097-4598},
  doi = {10.1002/mus.70353},
  language = {ENG},
}