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      Flexor Carpi Radialis Muscle: Anatomic Features and Electromyography Technique Under Ultrasound Control

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          Abstract

          The electromyographic assessment of the flexor carpi radialis muscle (FCRM) in the context of an upper limb extensors’ deficiency helps physicians in differentiating radial nerve damage from C7 radicular impairment. Ultrasound (US)-guided electromyography (EMG) is mandatory to locate this muscle, particularly in the case of muscle atrophy, denervation, and neuromuscular disorders. The aim of this manuscript is to illustrate the anatomical specific features of the FCRM and the technical procedure of FCRM EMG with US guidance.

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          Muscle ultrasound in neuromuscular disorders.

          Machiel J. Zwarts, Sigrid Pillen, Ilse M P Arts (2008)
          Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in the detection of neuromuscular disorders. Although not investigated in large series of patients, different neuromuscular disorders tend to show specific changes on muscle ultrasound, which can be helpful in differential diagnosis. For example, Duchenne muscular dystrophy results in a severe, homogeneous increase of muscle echo intensity with normal muscle thickness, whereas spinal muscular atrophy shows an inhomogeneous increase of echo intensity with severe atrophy. A major advantage of muscle ultrasound, compared to other imaging techniques, is its ability to visualize muscle movements, such as muscle contractions and fasciculations. This study reviews the possibilities and limitations of ultrasound in muscle imaging and its value as a diagnostic tool in neuromuscular disorders.
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            Accuracy of electromyography needle placement in cadavers: non-guided vs. ultrasound guided.

            Andrea J. Boon, Theresa Oney-Marlow, Naveen Murthy … (2011)
            Accuracy of needle electromyography is typically ensured by use of anatomical landmarks and auditory feedback related to voluntary activation of the targeted muscle; however, in certain clinical situations, landmarks may not be palpable, auditory feedback may be limited or not present, and targeting a specific muscle may be more critical. In such settings, image guidance might significantly enhance accuracy.
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              Resident Accuracy of Electromyography Needle Electrode Placement Using Ultrasound Verification

              Kristopher Karvelas, Craig H. Ziegler, Monica Rho (2016)
              Electromyography (EMG) and musculoskeletal (MSK) ultrasound (US) are core learning objectives during physical medicine and rehabilitation (PM&R) training. However, there have been no prior studies using MSK US to assess the acquisition of EMG procedural skills during residency training. This study aims to demonstrate the differences in skillful needle placement between junior and senior physiatry residents. The integration of both EMG and MSK US may have tremendous potential for additional learning opportunities related to electrodiagnostic education.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 12 August 2022
                Publication date (Electronic, collection): August 2022
                Volume: 14
                Issue: 8
                Electronic Location Identifier: e27936
                Affiliations
                [1 ] Department of Physiology, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN
                [2 ] Department of Physical Medicine and Rehabilitation, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN
                [3 ] Department of General Surgery, Research Laboratory LR21ES04, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN
                [4 ] Department of Physical Medicine and Rehabilitation, Research Laboratory LR20ES09, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN
                Author notes
                Article
                DOI: 10.7759/cureus.27936
                PMC ID: 9464466
                SO-VID: 5323a397-0d82-469c-8db6-ff4e3a4bbeb7
                Copyright © Copyright © 2022, Elleuch et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 23 July 2022
                Categories
                Subject: Medical Education
                Subject: Physical Medicine & Rehabilitation
                Subject: Anatomy

                Keywords: extensors' deficiency,electromyography,ultrasound,anatomy,flexor radialis carpi muscle
                Data availability:
                Keywords: extensors' deficiency, electromyography, ultrasound, anatomy, flexor radialis carpi muscle

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