@article{article,
  keywords = {High resolution ultrasonography, leprosy, ultrasonography},
  author = {Venugopal R and Binesh V and Puthussery P and George S and Asokan N},
  title = {Comparison of High Resolution Ultrasonography with Clinical Examination in the Assessment of Peripheral Nerve Involvement in Leprosy.},
  abstract = {<p><b>Context: </b>Assessment of peripheral nerves in leprosy by clinical methods is subject to considerable inter-observer variability. High resolution ultrasonography (HRUS) can assess peripheral nerves more objectively.</p><p><b>Aims: </b>To compare the findings of peripheral nerve involvement in newly diagnosed cases of leprosy by clinical and sonological methods.</p><p><b>Settings and Design: </b>Cross sectional study in a tertiary care teaching hospital.</p><p><b>Subjects and Methods: </b>Four pairs of peripheral nerves of 40 newly diagnosed patients with leprosy were examined clinically and by HRUS.</p><p><b>Statistical Analysis Used: </b>Agreement between clinical examination and HRUS using kappa statistic; sensitivity; specificity; and predictive values.</p><p><b>Results: </b>Of the 320 nerves examined, 71 (22.18\%) were abnormal clinically and 63 (19.7\%) sonologically. Sonological abnormalities were increased cross sectional area ( = 63; 100\%), hypoechogenicity with loss of fascicular architecture ( = 46; 73\%) and increased vascularity ( = 35; 55.6\%). There was moderate agreement (Cohen{\textquoteright}s Ḳ = 0.59) between clinical and sonological findings. HRUS findings were abnormal in 18 (7.2\%) nerves that were clinically normal. HRUS was normal in 26 (36.6\%) nerves which were clinically abnormal. Sensitivity of HRUS compared to clinical examination was 63\%; specificity 92.7\%; positive predictive value 71.4\%; and negative predictive value 89.9\%. Increased cross sectional area agreed with clinical findings the most.</p><p><b>Conclusions: </b>HRUS has low sensitivity (63\%) and high specificity (92.7\%) to identify abnormal peripheral nerves in leprosy, compared to clinical examination. It could detect abnormality of some ( = 18, 7.2\%) clinically normal nerves, but showed normal findings of some nerves ( = 26, 36.6\%), which were considered clinically abnormal.</p>},
  year = {2021},
  journal = {Indian dermatology online journal},
  volume = {12},
  pages = {536-540},
  month = {01/2021},
  issn = {2229-5178},
  url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354420/},
  doi = {10.4103/idoj.IDOJ_720_20},
  language = {eng},
}