Journal article
Atraumatic Main-En-Griffe due to Ulnar Nerve Leprosy
Polish journal of radiology, Vol.81, pp.1-4
01/01/2016
DOI: 10.12659/PJR.894850
PMCID: PMC4702610
PMID: 26788223
Abstract
Background: Leprosy is the most common form of treatable peripheral neuropathy. However, in spite of effective chemotherapeutic agents, neuropathy and associated deformities are seldom ameliorated to a significant extent. This necessitates early diagnosis and treatment. Clinical examination of peripheral nerves is highly subjective and inaccurate. Electrophysiological studies are painful and expensive. Ultrasonography circumvents these demerits and has emerged as the preferred modality for probing peripheral nerves.
Case Report: We describe a 23-year-old male who presented with weakness and clawing of the medial digits of the right hand (main-en-griffe) and a few skin lesions since eighteen months. The right ulnar nerve was thickened and exquisitely tender on palpation. Ultrasonography revealed an extensive enlargement of the nerve with presence of intraneural color Doppler signals suggestive of acute neuritis. Skin biopsy was consistent with borderline tuberculoid leprosy with type 1 lepra reaction. The patient was started on WHO multidrug therapy for paucibacillary leprosy along with antiinflammatory drugs. Persistence of vascular signals at two months' follow-up has led to continuation of the steroid therapy. The patient is compliant with the treatment and is on monthly follow-up.
Conclusions: In this manuscript, we review multitudinous roles of ultrasonography in examination of peripheral nerves in leprosy. Ultrasonography besides diagnosing enlargement of nerves in leprosy and acute neuritis due to lepra reactions, guides the duration of anti-inflammatory therapy in lepra reactions. Further, it is relatively inexpensive, non-invasive and easily available. All these features make ultrasonography a preferred modality for examination of peripheral nerves.
Details
- Title: Subtitle
- Atraumatic Main-En-Griffe due to Ulnar Nerve Leprosy
- Creators
- Yashant Aswani - Topiwala National Medical College & BYL Nair Charitable HospitalShenaz Saifi - Topiwala National Medical College & BYL Nair Charitable Hospital
- Resource Type
- Journal article
- Publication Details
- Polish journal of radiology, Vol.81, pp.1-4
- Publisher
- Int Scientific Information Inc
- DOI
- 10.12659/PJR.894850
- PMID
- 26788223
- PMCID
- PMC4702610
- ISSN
- 0137-7183
- eISSN
- 1899-0967
- Number of pages
- 4
- Language
- English
- Date published
- 01/01/2016
- Academic Unit
- Radiology
- Record Identifier
- 9984318722602771
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