Ultrasonography in Diagnosis of Polyneuropathy

Primary outcomes

1. Clinical examination

   Time frame: Through study completion, an average 2 years.

   • Myotatic reflexes (biceps, triceps, finger flexors, patellar, Achilles, deep abdominal): 1-absent, 2-reduced or 3-present with facilitation.

   • Muscle atrophy: 1-no atrophy, 2-mild, 3-moderate or4-severe atrophy
   • Muscle strength of lower and upper limbs with Medical Research Council (MRC) scale (0-5/5): shoulder abduction, elbow flexion and extension, wrist flexion and extension, fingers flexion, extension and abduction, hip flexion, extension, abduction and adduction, knee flexion and extension, ankle dorsal flexion, plantar flexion, eversion and inversion, thumb flexion and extension.
   • Touch sensation in all dermatomes with cotton wool: 1-normal sensation, 2-mild, 3-severe or 4-absent.

2. Electrodiagnostic studies

   Time frame: Through study completion, an average 2 years.

   • Motor nerve conduction studies in median, ulnar, radial, fibular and tibial: distal motor latency, compound muscle action potential (CMAP) amplitude, duration and area, conduction velocity.
   • Sensory nerve conduction studies in median, ulnar, superficial radial, superficial fibular and sural nerve: latency, sensory nerve action potential (SNAP) amplitude and velocity

3. Ultrasonography

   Time frame: Through study completion, an average 2 years.

   Cross-sectional area (CSA) and shear-wave velocity (SV) of:

   • median nerve at wrist, forearm, elbow and upper arm
   • ulnar nerve at wrist, forearm, elbow and upper arm
   • radial nerve at elbow and upper arm
   • vagus nerve
   • brachial plexus (C5,6 and 7)
   • fibular nerve at capitulum fibulae and popliteal fossa
   • tibial nerve at the medial malleolus and popliteal fossa
   • sciatic nerve
   • sural nerve

4. Patient history

   Time frame: Through study completion, an average 2 years.

   • demographic data: sex, date of birth, height, weight
   • symptoms duration (months), symptoms, therapy