Role of Ultrasonography in Peripheral Nerve Involvement in Leprosy: A Cross-sectional Study

Abstract

Leprosy is a chronic infectious disease with severe morbidity. The clinical skill of recognizing skin lesions of leprosy and testing for anesthesia is declining. It can only detect the presence of neuropathy, which indicates that there is already a substantial amount of nerve damage. Being one of most common treatable peripheral nerve disorders there is a need to diagnose early involvement of nerves to prevent disability. USG can show the detailed morphological changes in the nerve and can emerge as an evolving tool in early screening of peripheral nerve involvement in leprosy. Aims and Objectives: To assess the role of USG in identifying patterns of nerve involvement across the spectrum of leprosy and to compare the sonographic findings of peripheral nerves with clinical assessment. Results: Out of 20 cases of Leprosy (11 of MB and 9 of PB Leprosy), cross sectional area of median and ulnar nerve were significantly increased in patients with MB as compared to PB, however both PB and MB patients showed increased CSA as compared to normal limit for healthy individuals. The degree of morphological changes on USG correlated strongly with the symptoms of the patient. Endo-neural abscess formation was demonstrated in few cases. Conclusion: USG is a an excellent portable cost-friendly & non-invasive modality for imaging of peripheral nerves providing a high resolution spatial image that can be an important tool in classification , early detection and management of leprosy.