Ultrasound imaging of the brachial plexus in healthy adults and those with neurogenic thoracic outlet syndrome

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Ultrasound of the brachial plexus (BP) is a readily available and informative imaging method. Good knowledge of normal BP anatomy and its variations, as well as the ultrasound technique for examining the BP, is the key to success. We present an ultrasound technique for BP assessment in healthy adults and patients with neurogenic thoracic outlet syndrome.

About the authors

Irina Kh. Mukhambetalieva

Medical Center «Clinic of neuromuscular diseases»

Author for correspondence.
Email: i.mukhambetalieva@hotmail.com
Russian Federation, Moscow

Evgeniya S. Druzhinina

Pirogov Russian National Research Medical University

Email: i.mukhambetalieva@hotmail.com
Russian Federation, Moscow

Dmitry S. Druzhinin

Yaroslavl State Medical University

Email: i.mukhambetalieva@hotmail.com
Russian Federation, Yaroslavl


  1. Griffith J.F. Ultrasound of the Brachial Plexus. Semin Musculoskelet Radiol 2018; 22: 323–333. doi: 10.1055/s-0038-1645862. PMID: 29791960.
  2. Baute V., Strakowski J.A., Reynolds J.W. et al. Neuromuscular ultrasound of the brachial plexus: A standardized approach. Muscle Nerve 2018; 58: 618–624. doi: 10.1002/mus.26144. PMID: 29672872.
  3. Kerr A.T. The brachial plexus of nerves in man, the variations in its formation and branches. Am J Anat 1918; 23: 285–395. doi: 10.1002/aja.1000230205.
  4. Franco C.D., Williams J.M. Ultrasound-guided interscalene block: reevaluation of the "stoplight" sign and clinical implications. Reg Anesth Pain Med 2016; 41: 452–459. doi: 10.1097/AAP.0000000000000407. PMID: 27203394.
  5. Leonhard V., Caldwell G., Goh M. et al. Ultrasonographic diagnosis of thoracic outlet syndrome secondary to brachial plexus piercing variation. Diagnostics 2017; 7: 40. doi: 10.3390/diagnostics7030040. PMID: 28677632.
  6. Leonhard V., Smith R., Caldwell G., Smith H.F. Anatomical variations in the brachial plexus roots: implications for diagnosis of neurogenic thoracic outlet syndrome. Ann Anat 2016; 206: 21–26. doi: 10.1016/j.aanat.2016.03.011. PMID: 27133185.
  7. Huelke D.F. A study of the transverse cervical and dorsal scapular arteries. Anat Rec 1958; 132: 233–245. doi: 10.1002/ar.1091320302. PMID: 13637401.
  8. Natsis K., Totlis T., Didagelos M. et al. Scalenus minimus muscle: overestimated or not? An anatomical study. Am Surg 2013; 79: 372–374. PMID: 23574846.
  9. Kumar A., Kumar A., Sinha C. et al. Topographic sonoanatomy of infraclavicular brachial plexus: variability and correlation with anthropometry. Anesth Essays Res 2018; 12: 814–818. doi: 10.4103/aer. AER_140_18. PMID: 30662113.
  10. Bianchi S., Martinoli С. Ultrasound of the musculoskeletal system. Medical Radiology 2007. doi: 10.1007/978-3-540-28163-4.
  11. Haun D.W., Cho J.C., Kettner N.W. Normative cross-sectional area of the C5-C8 nerve roots using ultrasonography. Ultrasound Med Biol 2010; 36: 1422–1430. doi: 10.1016/j.ultrasmedbio.2010.05.012. PMID: 20800169.
  12. Naumova E.S., Nikitin S.S., Druzhinin D.S. [Quantitative sonographic characteristics of peripheral nerves in healthy people]. Annaly klinicheskoy i eksperimental’noy nevrologii 2017; 11(1): 55–61. doi: 10.18454/ACEN.2017.1.6162. (In Russ.)
  13. Karmakar M.K., Pakpirom J., Songthamwat B., Areeruk P. High definition ultrasound imaging of the individual elements of the brachial plexus above the clavicle. Reg Anesth Pain Med 2020; 45: 344–350. doi: 10.1136/rapm-2019-101089. PMID: 32102798.
  14. Arányi Z., Csillik A., Böhm J., Schelle T. Ultrasonographic identification of fibromuscular bands associated with neurogenic thoracic outlet syndrome: the "wedge-sickle" sign. Ultrasound Med Biol 2016; 42: 2357–2366. doi: 10.1016/j.ultrasmedbio.2016.06.005. PMID: 27444863.
  15. Drukhinin D.S., Nikitin S.S., Boriskina L.M. et al. [The role of ultrasound examination of the brachial plexus in superior aperture syndrome]. Nervno-myshechnyye bolezni 2020; 10(1): 43–52. doi: 10.17650/2222-8721-2020-10-1-43-52. (In Russ.)
  16. Murtazina A.F., Nikitin S.S., Naumova E.S. [Syndrome of the upper thoracic outlet: clinical and diagnostic features]. Nervno-myshechnyye bolezni 2017; 7(4): 10–19. doi: 10.17650/2222-8721-2017-7-4-10-19. (In Russ.)
  17. Hixson K.M., Horris H.B., McLeod T.C.V., Bacon C.E.W. The diagnostic accuracy of clinical diagnostic tests for thoracic outlet syndrome. J Sport Rehabil 2017; 26: 459–465. doi: 10.1123/jsr.2016-0051. PMID: 27632823.
  18. Orlando M.S., Likes K.C., Mirza S. et al. Preoperative duplex scanning is a helpful diagnostic tool in neurogenic thoracic outlet syndrome. Vasc Endovascular Surg 2016; 50: 29–32. doi: 10.1177/1538574415623650. PMID: 26744377.
  19. Fried S.M., Nazarian L.N. Dynamic neuromusculoskeletal ultrasound documentation of brachial plexus/thoracic outlet compression during elevated arm stress testing. Hand (N Y) 2013; 8: 358–365. doi: 10.1007/s11552-013-9523-8. PMID: 24426950.
  20. Odderson I.R., Chun E.S., Kolokythas O., Zierler R.E. Use of sonography in thoracic outlet syndrome due to a dystonic pectoralis minor. J Ultrasound Med 2009; 28: 1235–1238. doi: 10.7863/jum.2009.28.9.1235. PMID: 19710222.

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Copyright (c) 2020 Mukhambetalieva I.K., Druzhinina E.S., Druzhinin D.S.

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