02595nas a2200241   4500000000100000008004100001260001000042653002100052100001300073700001500086700001700101700001500118700001400133700001400147700001300161700001200174245010300186856009800289300001200387490000700399520193300406022001402339       2021                            d  bLepra10aGeneral Medicine1 aReddy YM1 aMurthy JMK1 aPidaparthi L1 aJaiswal SK1 aKiran ESS1 aPenneru A1 aNukala R1 aKumar S00aSonographic characteristics of median nerve neuropathy in Hansen’s disease: a case-control study  uhttps://leprosyreview.org/admin/public/api/lepra/website/getDownload/6142aafdafaac14a0367c532  a207-2170 v923 a<p>Background and objectives</p>

<p>High-resolution ultrasonography (HRUS) has become a vital imaging tool in the management of leprosy. This case-control study analyzed the sonographic data on median nerves in leprosy and healthy controls to identify the features characteristic of leprosy.</p>

<p>Methods</p>

<p>Newly diagnosed and treatment naïve Hansen’s patients of both sexes and aged &gt;16 years were included in the study. The control group included prospectively enrolled healthy subjects. Nerve conduction studies were performed in all. HRUS of the median nerve was performed using a Philips HD15 machine. HRUS parameters studied included cross-sectional area (CSA) of the nerve, fascicular architecture and abnormal blood flow (by colour Doppler). CSA was measured at the wrist (S1), 5&nbsp;cm above the wrist (S2), 10 cm above the wrist (S3), mid-forearm (S4) and at the elbow&nbsp;(S5).</p>

<p>Results</p>

<p>30 median nerves from 22 cases of leprosy and 30 nerves from 15 healthy subjects were compared. Among cases, 8 were borderline tuberculoid, 9 borderline lepromatous, 3 lepromatous leprosy, and 2 indeterminate leprosy. Abnormal motor (76.7%) and sensory conduction (96.7%) was noted in the patient group. The mean CSA was 18.5&nbsp;mm<sup>2</sup>&nbsp;at S1, 20.3&nbsp;mm<sup>2</sup>&nbsp;at S2, 14.1&nbsp;mm<sup>2</sup>&nbsp;at S3, 9.1&nbsp;mm<sup>2</sup>&nbsp;at S4, and 8.1&nbsp;mm<sup>2</sup>&nbsp;at S5. The CSA at S1 and S2 were significantly higher compared to other sites. CSA values were significantly higher in patients compared to controls. The fascicular architecture was distorted in patients - grade II (33.3%), III (40.0%) and IV (20%), and hypervascularity was noted in 26.6%.</p>

<p>Conclusion</p>

<p>HRUS depicted characteristic features of the median nerve in leprosy - maximum enlargement in the distal forearm with distorted fascicular architecture.</p>
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