British Leprosy Relief Association
Ultrasonography versus clinical examination in detecting leprosy neuropathy
M. S. Kumaran et al.
Nerve ultrasonography in leprosy
aPost Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India
Correspondence to: Muthu Sendhil Kumaran, Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India (e-mail: drsen˙email@example.com)
Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae), primarily effecting nerve and skin. Ultrasonography (USG) in the diagnosis of nerve involvement in leprosy is still in a preliminary stage, but it can be used to identify the early changes in the nerves.
To assess the role of USG in identifying nerve involvement across the spectrum of leprosy.
Thirty newly diagnosed, untreated cases of leprosy were recruited and classified into paucibacillary (PB) and multibacillary (MB) on basis of histopathology findings on skin biopsy. USG of ulnar nerve (UN), median nerve (MN), lateral popliteal nerve (LPN) and posterior tibial nerve (PTN) was done to identify the changes across the disease spectrum.
Thirty patients (16 multibacillary, MB and 14 paucibacillary, PB) with a mean age of 28.83 ± 18.57 years, M:F of 2:1 were studied. The nerves were significantly enlarged in USG examination in the MB group as compared to PB group for UN, MN, LPN and PTN (P = 0.004, 0.018, 0.019 and 0.020 respectively). 41 nerves that were not thickened clinically were found to be enlarged on USG (UN 3, MN 21, LPN 6 and PTN 11).
USG can be a useful tool for identifying early nerve changes, as compared to clinical examination, as USG is more sensitive. Hence it may help to identify nerve involvement in an early stage and initiate treatment before any severe damage occurs.