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. 2021 Jul 1;29(13):e646-e654.
doi: 10.5435/JAAOS-D-20-00322.

Interpretation of Electrodiagnostic Studies: How to Apply It to the Practice of Orthopaedic Surgery

Christopher J Dy  1 , Berdale S Colorado, Andrew J Landau, David M Brogan
Affiliations

Interpretation of Electrodiagnostic Studies: How to Apply It to the Practice of Orthopaedic Surgery

Christopher J Dy et al. J Am Acad Orthop Surg. .

Abstract

Electrodiagnostic studies may help orthopaedic surgeons to identify and confirm nerve pathology, determine severity of disease, localize the lesion, identify concomitant or alternative pathology, and prognosticate potential outcomes with nonoperative or operative treatment. Surgeons should recognize the indications for electrodiagnostic studies, principles of their performance, and how to assess the primary data generated by the examination and how it can inform their treatment plans.

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Figures

Figure 1
Figure 1
A. Median nerve sensory nerve conduction study setup. B. Median nerve motor nerve conduction study setup. C. Electromyography needle insertion into abductor pollicis brevis.
Figure 1
Figure 1
A. Median nerve sensory nerve conduction study setup. B. Median nerve motor nerve conduction study setup. C. Electromyography needle insertion into abductor pollicis brevis.
Figure 1
Figure 1
A. Median nerve sensory nerve conduction study setup. B. Median nerve motor nerve conduction study setup. C. Electromyography needle insertion into abductor pollicis brevis.
Figure 2
Figure 2
A. Motor nerve conduction study from the first dorsal interosseous muscle in a patient with mild cubital tunnel syndrome. Note the normal compound motor action potential (CMAP) amplitude levels are normal, but there is some slight slowing in the nerve conduction velocity across the elbow. B. Motor nerve conduction study from the abductor digiti minimi muscle in a patient with severe cubital tunnel syndrome. There is muscle wasting and loss of two-point discrimination on this patient’s clinical exam. Note the drastically decreased compound motor action potential (CMAP) amplitude levels in addition to marked slowing in the nerve conduction velocity across the elbow.
Figure 2
Figure 2
A. Motor nerve conduction study from the first dorsal interosseous muscle in a patient with mild cubital tunnel syndrome. Note the normal compound motor action potential (CMAP) amplitude levels are normal, but there is some slight slowing in the nerve conduction velocity across the elbow. B. Motor nerve conduction study from the abductor digiti minimi muscle in a patient with severe cubital tunnel syndrome. There is muscle wasting and loss of two-point discrimination on this patient’s clinical exam. Note the drastically decreased compound motor action potential (CMAP) amplitude levels in addition to marked slowing in the nerve conduction velocity across the elbow.
Figure 3.
Figure 3.
Waveforms seen during insertion, resting, and activation phases of EMG. (Reproduced with permission from Gelberman RH: Operative Nerve Repair and Reconstruction [Fig 10–2]; Ed: Gelberman RH, 1991. Lippincott)
See this image and copyright information in PMC

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