Eric H Williams

BACKGROUND: The anatomical basis for the surgical techniques used to treat tarsal tunnel syndrome is not well studied. The authors sought to evaluate their hypotheses that (1) pronation and pronation with plantar flexion of the intact foot would have higher pressures than the intact foot in other positions; (2) decompression surgery would significantly lower the pressure in all three tunnels in all foot positions, and roof incision plus septum excision would lower the pressure further in ...

OBJECTIVE: To examine diagnostic accuracy of semiquantitative and qualitative magnetic resonance neurography criteria in common peroneal nerve (CPN) neuropathy.

MATERIALS AND METHODS: Institutional review board approval was obtained with a waiver of informed consent for this Health Insurance Portability and Accountability Act-compliant retrospective study. A review of 28 knees in 28 subjects (12 males and 16 females; age range, 13-84 years; mean [SD] age, 42 [20] years) who had undergone ...

BACKGROUND: Intercostal neuralgia due to surgical injury of the intercostal nerve is difficult to treat. No treatment modality has given effective pain relief. Experience with other painful neuromas has demonstrated that neuroma resection and muscle implantation has been effective in the upper and lower extremities. This approach was applied to patients with intercostal neuralgia.

METHODS: A retrospective review was done of 5 consecutive patients who have had neurectomy of one or more ...

BACKGROUND: Although distal tibial nerve compression is well recognized, proximal tibial nerve compression remains a rarely recognized clinical condition. This report defines the presentation, diagnosis, surgical decompression technique, and clinical outcome of neurolysis of the tibial nerve at this soleal sling compression site.

METHODS: Forty-nine patients with 69 proximal tibial nerves (20 bilateral) were stratified retrospectively into three groups: neuropathy (n = 10), failed tarsal ...

ObjectiveTo assess the feasibility, technical success, and effectiveness of high-resolution magnetic resonance (MR)-guided posterior femoral cutaneous nerve (PFCN) blocks.Materials and methodsA retrospective analysis of 12 posterior femoral cutaneous nerve blocks in 8 patients [6 (75 %) female, 2 (25 %) male; mean age, 47 years; range, 42–84 years] with chronic perineal pain suggesting PFCN neuropathy was performed. Procedures were performed with a clinical wide-bore 1.5-T MR imaging ...

PURPOSE: To evaluate whether the addition of the three-dimensional diffusion-weighted reversed fast imaging with steady state free precession (3D DW-PSIF) sequence improves the identification of peripheral nerves in the distal extremities.

MATERIALS AND METHODS: Twelve MR neurography (MRN) studies of the distal upper extremity and 12 MRN studies of distal lower extremity were evaluated. From the 24 subjects who were enrolled, 10 had clinically suspected peripheral neuropathy, whereas 14 ...

Purpose To determine if 3-T magnetic resonance (MR) neurography-guided retroperitoneal genitofemoral nerve (GFN) blocks are safe and effective for the diagnosis of genitofemoral neuralgia. Materials and Methods Following institutional review board approval and informed consent, 26 subjects (16 men, 10 women; mean age, 42 years [range, 24-78 years]; mean body mass index, 28 kg/m2 [range, 20-35 kg/m2]) with intractable groin pain were included. By using a 3-T MR imaging system, ...

OBJECTIVE: The sciatic nerve may normally exhibit mild T2 hyperintensity in MR neurography (MRN) images, rendering assessment of sciatic neuropathy difficult. The purpose of this case-control study was to evaluate whether a quantitative and qualitative analysis of the sciatic nerves and regional skeletal muscles increases the accuracy of MRN in detecting sciatic neuropathy.

MATERIALS AND METHODS: We retrospectively reviewed the MRN studies of the pelvis and thighs of 34 subjects (12 men ...

OBJECTIVE: The purpose of this study was to retrospectively determine the accuracy of high-resolution MR neurography (MRN) in presurgical evaluation before repeat tarsal tunnel surgery.

MATERIALS AND METHODS: Ten MRN studies of nine patients (one man, eight women; mean age, 44.4 years; range, 23-67 years) who had been referred to a peripheral nerve specialist because of persistent symptoms after tarsal tunnel release were reviewed. The MRN findings studied included presence and location ...

A 3-cm gap in the ulnar nerve at the elbow in a subhuman primate was the first model of nerve regeneration across a polyglycolic, bioabsorbable conduit. When a prospective trial was begun in humans, the first clinically available bioabsorbable conduit, the Neurotube, was utilized to reconstruct sensory nerves, but motor nerve injuries were not included. Thus, we sought to evaluate our patients with short-gap motor nerve injuries repaired with bioabsorbable conduits. We performed a ...

BACKGROUND: Breast procedures are among the most common surgeries performed by Plastic Surgeons. The prevalence of persistent pain remains unknown. Our experience has been that persistent breast pain is often related to intercostal nerve trauma. The purpose of this article was to increase awareness of this problem while describing the diagnostic and management strategies for patients with post-operative breast pain.

METHODS: A retrospective review of 10 patients with breast pain was ...

ObjectiveTo assess the diagnostic accuracy and observer performance of 3-Tesla magnetic resonance neurography (MRN) in the evaluation of meralgia paresthetica (MP).Materials and methodsTwo independent readers were blinded to the clinical diagnosis and evaluated the MRN studies of the pelvis of 11 patients with MP and 28 control participants. In each study, the lateral femoral cutaneous nerves were assessed for signal alteration and/or neuroma formation, indicating lateral femoral ...

MR imaging of peripheral nerves has been described in relation to abnormalities such as nerve injury, entrapment, and neoplasm. Neuroma formation is a known response to peripheral nerve injury, and here we correlate the MRN appearance of postinjury neuroma formation with intraoperative findings. We also present the MR imaging features of surgical treatment with a synthetic nerve tube and nerve wrap on postoperative follow-up imaging.

The lumbosacral plexus comprises a network of nerves that provide motor and sensory innervation to most structures of the pelvis and lower extremities. It is susceptible to various traumatic, inflammatory, metabolic, and neoplastic processes that may lead to lumbrosacral plexopathy, a serious and often disabling condition whose course and prognosis largely depend on the identification and cure of the causative condition. Whereas diagnosis of lumbrosacral plexopathy has traditionally ...

Primary compression of the tibial nerve beneath the fibromuscular sling of the origin of the soleus muscle is rarely discussed in the literature. To evaluate the location and characteristics of the soleal fibromuscular sling and its relationship to the tibial nerve, 36 cadaver limbs were dissected. The leg length, location of soleal fibromuscular sling, presence of a thickened fibrous band at the soleal sling, and narrowing in the tibial nerve were recorded. The average leg length was ...