Similar case to the one presented in 2018. Incidental peripheral nerve enlargement on knee MRI in a 39 yo M with a MMT. No history of neuropathy. No denervation. Would you suggest CMT, less likely CIDP?
TIA,
Liz Carpenter
Thank you for the numerous replies to this incidental nerve finding.
Favorite diagnosis was Charcot-Marie-Tooth disease, for which Avneesh Chhabrah says this is an Aunt Minnie. He further elaborates:
“CMT type 1A
High plantar arches
Cavus type foot
Demyelination may not give denervation- just slowed conduction
Axonal type II – can have denervation”
Second favorite diagnosis was CIDP, for which Hilary Umans says the severity can be variable and 10% of people may be minimally symptomatic or asymptomatic.
I FINALLY got in touch with the out of state orthopedic surgeon who says he is unaware of any neurological problems and will ask the patient about any symptoms at her next visit. He has not looked at her feet to see whether she has pes cavus.
Thanks
John Symanski
21 year old woman with knee pain after motor vehicle collision.
She has enlargement and increased T2-hyperintensity of the fascicles in her common peroneal and tibial nerves, unchanged from an MRI 3 years ago for patellofemoral dislocation. This is most conspicuous near the sciatic bifurcation and less severe on the more inferior images. No cutaneous lesions to suggest neurofibromatosis. No muscle denervation to suggest a demyelinating peripheral neuropathy. Could it still be one of these entities? Any other thoughts?
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
Similar case to the one presented in 2018. Incidental peripheral nerve enlargement on knee MRI in a 39 yo M with a MMT. No history of neuropathy. No denervation. Would you suggest CMT, less likely CIDP?
TIA,
Liz Carpenter
Thank you for the numerous replies to this incidental nerve finding.
Favorite diagnosis was Charcot-Marie-Tooth disease, for which Avneesh Chhabrah says this is an Aunt Minnie. He further elaborates:
“CMT type 1A
High plantar arches
Cavus type foot
Demyelination may not give denervation- just slowed conduction
Axonal type II – can have denervation”
Second favorite diagnosis was CIDP, for which Hilary Umans says the severity can be variable and 10% of people may be minimally symptomatic or asymptomatic.
I FINALLY got in touch with the out of state orthopedic surgeon who says he is unaware of any neurological problems and will ask the patient about any symptoms at her next visit. He has not looked at her feet to see whether she has pes cavus.
Thanks
John Symanski
21 year old woman with knee pain after motor vehicle collision.
She has enlargement and increased T2-hyperintensity of the fascicles in her common peroneal and tibial nerves, unchanged from an MRI 3 years ago for patellofemoral dislocation. This is most conspicuous near the sciatic bifurcation and less severe on the more inferior images. No cutaneous lesions to suggest neurofibromatosis. No muscle denervation to suggest a demyelinating peripheral neuropathy. Could it still be one of these entities? Any other thoughts?
Thank you,
John Symanski
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