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. 2023 Apr;52(4):751-761.
doi: 10.1007/s00256-022-04214-2. Epub 2022 Nov 1.

Can MR neurography of the common peroneal nerve predict a residual motor deficit in patients with foot drop?

Steven P Daniels  1 , Andrew B Ross  2 , Darryl B Sneag  3 , Stephanie N Gardon  4 , Geng Li  5 , Amgad S Hanna  6 , Michael J Tuite  2
Affiliations

Can MR neurography of the common peroneal nerve predict a residual motor deficit in patients with foot drop?

Steven P Daniels et al. Skeletal Radiol. 2023 Apr.

Abstract

Objective: To determine if MR neurography of the common peroneal nerve (CPN) predicts a residual motor deficit at 12-month clinical follow-up in patients presenting with foot drop.

Materials and methods: A retrospective search for MR neurography cases evaluating the CPN at the knee was performed. Patients were included if they had electrodiagnostic testing (EDX) within 3 months of imaging, ankle and/or forefoot dorsiflexion weakness at presentation, and at least 12-month follow-up. Two radiologists individually evaluated nerve size (enlarged/normal), nerve signal (T2 hyperintense/normal), muscle signal (T2 hyperintense/normal), muscle bulk (normal/Goutallier 1/Goutallier > 1), and nerve and muscle enhancement. Discrepancies were resolved via consensus review. Multivariable logistical regression was used to evaluate for association between each imaging finding and a residual motor deficit at 12-month follow-up.

Results: Twenty-three 3 T MRIs in 22 patients (1 bilateral, mean age 52 years, 16 male) met inclusion criteria. Eighteen cases demonstrated common peroneal neuropathy on EDX, and median duration of symptoms was 5 months. Six cases demonstrated a residual motor deficit at 12-month follow-up. Fourteen cases underwent CPN decompression (1 bilateral) within 1 year of presentation. Three cases demonstrated Goutallier > 1 anterior compartment muscle bulk. Multivariable logistical regression did not show a statistically significant association between any of the imaging findings and a residual motor deficit at 12-month follow-up.

Conclusion: MR neurography did not predict a residual motor deficit at 12-month follow-up in patients presenting with foot drop, though few patients demonstrated muscle atrophy in this study.

Keywords: Common peroneal nerve; MR neurography; Peripheral nerve; Peripheral nerve injury.

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