Imaging of Anatomical Variants of the Lower Limb Nerves: Clinical and Preoperative Relevance

Semin Musculoskelet Radiol. 2023 Apr;27(2):136-152. doi: 10.1055/s-0043-1761956. Epub 2023 Apr 3.

Abstract

Anatomical variants of peripheral nerves of the lower limb are relatively frequent and vulnerable to injury if not considered by the surgeon. Surgical procedures or percutaneous injections are often performed without knowing the anatomical situation. In a patient with normal anatomy, these procedures are mostly performed smoothly without major nerve complications. But in the case of anatomical variants, surgery may be challenging as "new" anatomical prerequisites complicate the procedure. In this context, high-resolution ultrasonography as the first-line imaging modality to depict peripheral nerves, has become a helpful adjunct in the preoperative setting. It is crucial, on the one hand, to gain knowledge of anatomical nerve variants and, on the other hand, to depict the anatomical situation preoperatively, to minimize the risk of surgical trauma to a nerve and make surgeries safer.

MeSH terms

  • Humans
  • Peripheral Nerves* / diagnostic imaging
  • Peripheral Nerves* / surgery
  • Ultrasonography
  • Upper Extremity*