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Reference values for the cross-sectional area of normal radial nerve at two levels using high-resolution ultrasonography

Kunwar Pal Singh
Kunwar Pal Singh
, 
Achal Singh Goindi
Achal Singh Goindi
 e 
Kamlesh Gupta
Kamlesh Gupta
   | 18 giu 2021
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Article Category: research-paper
Pubblicato online: 18 giu 2021
Pagine: 112 - 126
Ricevuto: 02 feb 2021
Accettato: 20 apr 2021
DOI: https://doi.org/10.15557/jou.2021.0020
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© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

High-resolution ultrasonography of the radial nerve of the right upper limb done with the patient in supine position using a high-resolution linear transducer (5–18 MHz) at the level of the elbow just proximal to its bifurcation into the superficial sensory nerve and posterior interosseous nerve (level 1)
High-resolution ultrasonography of the radial nerve of the right upper limb done with the patient in supine position using a high-resolution linear transducer (5–18 MHz) at the level of the elbow just proximal to its bifurcation into the superficial sensory nerve and posterior interosseous nerve (level 1)

Fig. 2.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right and left upper limbs in the axial plane at level 1 in a 70-year-old male weighing 60 kg, with a height of 167 cm and a body mass index of 21.4 kg/m2. The mean cross-sectional area on the right ( A, B, C ) and left ( D, E, F ) sides are 2.4 mm2 and 2.5 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right and left upper limbs in the axial plane at level 1 in a 70-year-old male weighing 60 kg, with a height of 167 cm and a body mass index of 21.4 kg/m2. The mean cross-sectional area on the right ( A, B, C ) and left ( D, E, F ) sides are 2.4 mm2 and 2.5 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 3.

High-resolution ultrasonography of the radial nerve of the right upper limb done with the patient in supine position using a high-resolution linear transducer (5–18 MHz) at the anterolateral aspect of the mid-humerus just after it exits the spiral groove (level 2)
High-resolution ultrasonography of the radial nerve of the right upper limb done with the patient in supine position using a high-resolution linear transducer (5–18 MHz) at the anterolateral aspect of the mid-humerus just after it exits the spiral groove (level 2)

Fig. 4.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right and left upper limbs in the axial plane at level 2 in a 70-year-old male weighing 60 kg, with a height of 167 cm and a body mass index of 21.4 kg/m2. The mean cross-sectional area on the right ( A, B, C ) and left ( D, E, F ) sides are 4.5 mm2 and 4.8 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right and left upper limbs in the axial plane at level 2 in a 70-year-old male weighing 60 kg, with a height of 167 cm and a body mass index of 21.4 kg/m2. The mean cross-sectional area on the right ( A, B, C ) and left ( D, E, F ) sides are 4.5 mm2 and 4.8 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 5.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 63-year-old female weighing 87 kg, with a height of 162 cm and a body mass index of 33.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.4 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 63-year-old female weighing 87 kg, with a height of 162 cm and a body mass index of 33.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.4 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 6.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 63-year-old female weighing 87 kg, with a height of 162 cm and a body mass index of 33.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.2 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 63-year-old female weighing 87 kg, with a height of 162 cm and a body mass index of 33.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.2 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 7.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 64-year-old male weighing 83 kg, with a height of 180 cm and a body mass index of 25.6 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.8 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 64-year-old male weighing 83 kg, with a height of 180 cm and a body mass index of 25.6 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.8 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 8.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 64-year-old male weighing 83 kg, with a height of 180 cm and a body mass index of 25.6 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.4 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 64-year-old male weighing 83 kg, with a height of 180 cm and a body mass index of 25.6 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 2.9 mm2 and 5.4 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 9.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 26-year-old female weighing 53 kg, with a height of 154 cm and a body mass index of 22.3 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.6 mm2 and 3.5 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 26-year-old female weighing 53 kg, with a height of 154 cm and a body mass index of 22.3 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.6 mm2 and 3.5 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 10.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 26-year-old female weighing 53 kg, with a height of 154 cm and a body mass index of 22.3 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.7 mm2 and 3.6 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left, PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 26-year-old female weighing 53 kg, with a height of 154 cm and a body mass index of 22.3 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.7 mm2 and 3.6 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left, PT – point, VAL – value)

Fig. 11.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 21-year-old male weighing 55 kg, with a height of 154 cm and a body mass index of 23.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.7 mm2 and 3.9 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the right upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 21-year-old male weighing 55 kg, with a height of 154 cm and a body mass index of 23.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.7 mm2 and 3.9 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Fig. 12.

Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 21-year-old male weighing 55 kg, with a height of 154 cm and a body mass index of 23.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.8 mm2 and 3.8 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)
Ultrasonographic cross-sectional area values of the normal radial nerve (arrows) of the left upper limb in the axial plane at level 1 ( A, B, C ) and level 2 ( D, E, F ) in a 21-year-old male weighing 55 kg, with a height of 154 cm and a body mass index of 23.2 kg/m2. The mean cross-sectional areas at level 1 and level 2 are 1.8 mm2 and 3.8 mm2, respectively (yellow arrow – radial nerve, RT – right, LT – left. PT – point, VAL – value)

Cross-sectional area (cm2) of the radial nerve at two levels, and its relationship with body mass index

BMI No. of cases CSA level 1
Right P-value &r-value Left P-value &r-value
Mean SD Mean SD
18.5–23.0 63 0.02108 0.003902 r = 0.368 p = 0.001 0.02289 0.012558 r = –0.343 p = 0.045
23.1–25.0 61 0.02294 0.002996 0.02286 0.003150
>25.0 76 0.02417 0.002830 0.02392 0.002755

Cross-sectional area (cm2) of the radial nerve at two levels, and its relationship with weight

Weight (kg) No. of cases CSA level 1
Right P-value &r-value Left P-value &r-value
Mean SD Mean SD
≤60 49 0.01931 0.002597 r = 0.725 p = 0.001 0.02025 0.007380 r = 0.263 p = 0.045
61–70 90 0.02251 0.002163 0.02335 0.009055
>70 61 0.02610 0.002596 0.02557 0.002272

Mean cross-sectional area (cm2) of the radial nerves at levels 1 and 2

Level CSA
Mean SD
Level 1 0.023 0.003
Level 2 0.043 0.004
p -value 0.001

Cross-sectional area (cm2) of the radial nerve at two levels, and its relationship with age

Age group (years) No. of cases CSA level 1
Right P-value &r-value Left P-value &r-value
Mean SD Mean SD
18–30 51 0.02214 0.003787 r = 0.130 p = 0.067 0.02257 0.012087 r = 0.084 p = 0.239
31–50 79 0.02237 0.002928 0.02271 0.003159
≥50 70 0.02317 0.003633 0.02410 0.006411

Cross-sectional area (cm2) of the radial nerve at two levels, and its relationship with the dominant and non-dominant sides

Dominant side No. of cases CSA level 1
Right P-value &r-value Left P-value &r-value
Mean SD Mean SD
Left 11 0.02342 0.002244 r = –0.042 p = 0.556 0.02389 0.002424 r = –0.018 p = 0.802
Right 189 0.02279 0.003535 0.02324 0.007624

Cross-sectional area (cm2) of the radial nerve at two levels, and its relationship with height

Height No. of cases CSA level 1
Right P-value &r-value Left P-value &r-value
Mean SD Mean SD
≤160 54 0.01935 0.002298 r = –0.736 p = 0.001 0.02017 0.006965 r = –0.359 p = 0.001
161–170 110 0.02315 0.002379 0.02310 0.002869
>170 36 0.02705 0.002451 0.02844 0.013136

Mean cross-sectional area (cm2) of both radial nerves at two levels, and their relationship with patient sex

Sex No. of cases CSA level 1
Right P-value &r-value Left P-value &r-value
Mean SD Mean SD
Male 105 0.02443 0.003037 r = –0.488 p = 0.001 0.02494 0.008413 r = –0.237 p = 0.001
Female 95 0.02104 0.003058 0.02142 0.005664
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