Diagnosis of obstetric brachial plexus injury in a 2-year-old girl using high‑frequency ultrasonography

Pediatr Radiol. 2024 Feb;54(2):362-366. doi: 10.1007/s00247-023-05835-y. Epub 2023 Dec 28.

Abstract

We describe an unusual case of infant obstetric brachial plexus injury located in the cervical (C)5-C6 brachial plexus nerve, which was preoperatively diagnosed using high-frequency ultrasonography (US) at 2 years of age. The girl was diagnosed with a right clavicular fracture because of shoulder dystocia. She had been showing movement limitations of her entire right upper limb after fracture healing and was then referred to our hospital at 2 years of age. High-frequency US showed that the roots of the right brachial plexus ran continuously, but the diameter of C6 was thinner on the affected side than on the contralateral side (right 0.12 cm vs. left 0.20 cm). A traumatic neuroma had formed at the upper trunk, which was thicker (diameter: right 0.35 cm vs. left 0.23 cm; cross-sectional area: right 0.65 cm2 vs. left 0.31 cm2) at the level of the supraclavicular fossa. Intraoperative findings were consistent with ultrasound findings. Postoperative pathology confirmed brachial plexus traumatic neuroma.

Keywords: Birth injuries; Brachial plexus; Infant; Neuroma; Ultrasonography.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brachial Plexus Neuropathies* / diagnostic imaging
  • Brachial Plexus* / diagnostic imaging
  • Brachial Plexus* / injuries
  • Brachial Plexus* / surgery
  • Child, Preschool
  • Female
  • Fractures, Bone* / diagnostic imaging
  • Fractures, Bone* / surgery
  • Humans
  • Infant
  • Neuroma* / etiology
  • Neuroma* / pathology
  • Neuroma* / surgery
  • Pregnancy
  • Ultrasonography