Entrapment neuropathy is a term describing a type of neuropathy that is rather commonly encountered in clinical practice (carpal tunnel syndrome is one of the examples) and results from either compression, traction or structural impairment of the nerve [1] [2] [3]. As the nerve becomes compressed or "entrapped" in tissues after trauma or some other form of injury, the blood supply to the nerve is diminished, eventually causing edema, ischemia, necrosis and death of neuronal tissue if the structural deformity is not repaired promptly [4] [5]. During this process, typical symptoms of neuronal injury arise, such as pain, paresthesia, and numbness [1]. Depending on the affected nerve, both sensory and motor deficits can be observed. For example, deltoid weakness indicates axillary nerve entrapment; restriction of wrist flexion is present in the setting of median nerve compression, whereas loss of sensation in the dorsal proximal areas of the index finger, middle finger and the thumb suggests radial nerve entrapment [1] [2]. It must be noted that several nerves could be entrapped at more than one anatomical location, which is why recognizing associated signs and symptoms is pivotal for identifying the affected nerve [1] [2] [6]. The appearance of symptoms can be abrupt or slowly progressive [1].

• Soft Tissue Mass

  It may be caused by abnormal fascial bands, subluxation, or dislocation of the ulnar nerve over the medial epicondyle, trauma, or direct compression by soft tissue masses. [hindawi.com]

  masses Axilla - here the most common cause is compression. [en.wikipedia.org]

  MRI should be considered to rule out soft-tissue masses or other space-occupying lesions that may be compressing the nerve.18 Modern NCV study protocols are reliable in confirming the diagnosis and identifying lumbosacral nerve root pathology.56-58 Treatment [journals.lww.com]

• Limb Pain

  Página 212 - Jensen TS, Krebs B, Nielsen J, Rasmussen P: Immediate and longterm phantom limb pain in amputees — incidence, clinical characteristics and relationship to pre-amputation limb pain. Pain 21:267278, 1985. ‎ [books.google.es]

• Paresthesia

  Entrapment neuropathy is a rather common type of nerve injury in which mechanical factors lead to compression of the nerve and subsequent appearance of pain, paresthesias, and associated muscle abnormalities. [symptoma.com]

  When evaluating patients with unilateral leg pain and paresthesias, one should consider the possibility of entrapment of peripheral nerve. Electrodiagnostic studies are helpful in establishing the diagnosis. [ncbi.nlm.nih.gov]

• Foot Drop

  An entrapment neuropathy of the superficial peroneal can cause foot drop by extending the nerve, and placing traction on the L5 nerve root. This will result in the expected fibrillation of the foot extensor muscles. [tonymorris.github.io]

  Four patients had classical rheumatoid arthritis, while foot-drop developed in one man after trauma to the knee. In all five patients, a painful palpable enlargement in the popliteal area became most symptomatic with the [jamanetwork.com]

  In the leg with peroneal neuropathy, this might manifest as foot drop, the inability to hold the foot up when walking. With foot drop, the foot will slap on the ground or even “catch”: the ground when the foot swings through when walking. [neckandback.com]

  Symptoms can include: numbness, tingling, muscle weakness pain in the limbs loss of sensation in the hand (similar to carpal tunnel syndrome ) muscle weakness, making it difficult to lift the front part of the foot (foot drop) or the wrist (wrist drop [nhs.uk]

  This leads to a condition called " foot drop ," in which it becomes difficult to lift the foot. Neuropathy can affect nerves that control muscle movement (motor nerves) and those that detect sensations such as coldness or pain (sensory nerves). [webmd.com]

• Gait Ataxia

  Gait ataxia, with difficulty walking or frequent falls, is observed. [spineuniverse.com]

A delayed diagnosis of entrapment neuropathy and nerve compression may lead to irreversible neuronal injury and cause a significant impairment in daily life, thus early recognition of this clinical entity is of absolute necessity [3] [6]. One of the first steps toward the diagnosis is a detailed patient history that will determine the duration of symptoms and their severity, followed by a thorough physical examination, perhaps the pivotal part of the diagnostic workup [1] [6]. Depending on the cause and location of symptoms, a complete motor evaluation of muscle groups and the sensorium in the areas where the patient reports pain, paresthesias, or numbness, is the mainstay in revealing which nerve is injured [1] [6]. A presumptive diagnosis might be made solely on clinical findings, but imaging and electrophysiologic studies are highly useful in confirming entrapment neuropathy. Plain radiography, although important in delineating skeletal injuries as potential causes, is of no use in assessing nervous tissues [1]. For this reason, ultrasonography (US) and magnetic resonance imaging (MRI) are recommended but are not equally effective for all anatomical sites [1] [2] [6] [7]. A hypoechogenic appearance of the nerve, as well as edema, thickening, and fatty atrophy of the muscles supplied by the injured nerve, are frequent findings on US, whereas swelling and hyperintensity are seen on MRI studies [1] [4] [7]. Conversely, electromyography (EMG) and nerve conduction studies are often used in the setting of peripheral nerve injury and provide important clues in discerning between peripheral and central nerve injuries [1] [6].

Below, we describe the decision making process for the diagnosis and treatment of his pudendal neuropathy. [ncbi.nlm.nih.gov]

Entrapment neuropathies of the upper limb Clinical reasoning of neuropathic pain Thoracic outlet syndrome: Clinical presentation A neurodynamic approach to treatment A scapula mechanics approach to treatment Carpal tunnel syndrome Cervical radiculopathy [raynersmale.com]

Each of these groups of mononeuropathies has its own ensemble of epidemiologic patterns, clinical presentations, laboratory and radiologic findings, differential diagnosis, management principles and prognosis. [mayoclinic.pure.elsevier.com]

EMG and nerve conduction studies are typically performed to diagnose the extent and distribution of the damage, and to help with prognosis for recovery. [en.wikipedia.org]

However, the little research that has been done to determine the prognosis for individuals who have undergone surgery has focused on the patency rate of the arteries after surgery and the presence or absence of complications. [ncbi.nlm.nih.gov]

Prognosis Diagnostic delay is common; untreated ACNES can lead to functional disability and reduced quality of life resulting in high medical health care costs, highlighting the importance of the awareness of ACNES among medical professionals. [orpha.net]

Lastly, the etiological structure may be the descriptor, such as pronator teres syndrome. [mhmedical.com]

CONCLUSION: This prospective study depicts the etiologic factors, ultrasonographic features and treatment protocol of MSCNE which is usually an underestimated cause of the low-back pain. [ncbi.nlm.nih.gov]

Further, this is an extremely painful and distressing condition resulting in symptoms that can be very distracting from the actual etiology. I am not a medical expert, just an independent thinker who owns too many medical text books. [tonymorris.github.io]

Each of these groups of mononeuropathies has its own ensemble of epidemiologic patterns, clinical presentations, laboratory and radiologic findings, differential diagnosis, management principles and prognosis. [mayoclinic.pure.elsevier.com]

Popliteal artery ICD-10 codes A- initial encounter D- subsequent encounter S- sequela Popliteal Artery Entrapment Syndrome ICD-9 904.4 Injury to blood vessels of lower extremity; popliteal blood vessels Popliteal Artery Entrapment Syndrome Etiology / Epidemiology [eorif.com]

Summary Epidemiology Around 20% of patients with chronic abdominal pain have abdominal wall pain, which is often caused by ACNES. The prevalence in patients alleged to have functional abdominal pain is estimated to be 3-4%. [orpha.net]

EPIDEMIOLOGY The estimated incidence of abdominal wall pain is 1 in 1800 individuals [ 8 ]. [uptodate.com]

Therefore, cumulatively, only 69 of our 12,736 cases of CTS and UN-E satisfied the pathophysiologic and one of the anatomic requirements of the DCH. [n.neurology.org]

|Subscribe on iTunes| Session 36 – Moving Beyond ‘Trapped Nerves’ – Entrapment Neuropathy with Annina Schmid Annina Schmid is a Physiotherapist and associate professor whose research focusses on advancing our understanding of the pathophysiology of entrapment [chewshealth.co.uk]

Pathophysiology of nerve compression. Hand Clin. 18(2): 231-41. ↑ Tapadia, M., Mozaffar, T., & Gupta, R. (2010). Compression neuropathies of the upper extremity: update on pathophysiology, classification, and elecrodiagnostic findings. [physio-pedia.com]

“Pathophysiology of chronic groin pain in the athlete.” Int J Sports Med 1.1 (2000). (link) Anagnostopoulou, Sofia, et al. [blog.tmorris.net]

The pathophysiological changes following nerve compression 8 – 21 are dependent on the degree, rate, and duration of compression. [clinicalgate.com]

A thorough understanding of the anatomy of these nerves can prevent stapling in the areas of danger and thus greatly reduce the incidence of this complication. [ncbi.nlm.nih.gov]

Prevention Changing physical activities can often help reduce the injury, when nerve entrapment injuries are caught early. [minneapolisclinic.com]

My staff and I at the Nebraska Hand & Shoulder Institute, P.C. believe that prevention and elimination of painful or debilitating conditions of the upper and lower extremities can consistently be achieved. [carpaltunnelrelief.net]

Home remedies and prevention There are lots of things a person who has ulnar nerve entrapment can do at home to promote healing and recovery. These same steps can also prevent ulnar nerve entrapment from recurring or happening in the first place. [medicalnewstoday.com]

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