Diagnostics (Ultrasound & Nerve Studies – EMG)
Electrodiagnostic Nerve Studies (EMG/NCS)
Nerve studies are used to quickly identify nerve pathology and entrapment syndromes as can be seen in carpal tunnel syndrome, radiculopathy (pinched nerve in the neck or back) and peripheral neuropathy.
The test utilizes a stimulator to run small electrical currents through specific nerves which are then measured for their strength (amplitude) and velocity. It also utilizes a tiny needle that is inserted into selected muscles to measure the activity of the muscle and the nerves that innervate that muscle.
What is a Nerve Study?
Nerve studies evaluate the function of your peripheral nerves. They can identify pathologies such peripheral neuropathies, nerve injuries, compression syndromes and pinched nerves in the neck and back. Together with a detailed history, physical exam and imaging, nerve studies can help our team make a proper diagnosis and formulate a treatment plan.
There are two parts to the electrodiagnostic nerve test: nerve conduction study (NCS) and electromyography (EMG).
The nerve conduction study measures the velocity and strength of the electrical impulses in the motor and sensory nerves. Small sticky electrodes are placed on the skin over muscles and nerve endings in the extremities. Next, a hand-held electrical stimulator is used to deliver a small current to the nerves at different locations. The stimulated nerves fire their electrical impulse, which is measured by the electrodes. The velocity and strength of the impulse indicates the health of the nerve.
The EMG portion of the study measures the function of the muscles and the nerves that innervate them. This is done by inserting a fine needle into specific muscles in the extremities and the spine. If there is damage to the spinal nerve roots or the peripheral nerves, the EMG will show abnormal activity within the studied muscles.
What to Expect at Your Nerve Study
Dr. Sebastian is a physiatrist with extensive training in the peripheral nervous system. He will take all measures to make your nerve study as comfortable as possible while trying to get a precise diagnosis.
Step 1: He will examine the strength, sensation and reflexes in your extremities.
Step 2: He will apply the electrodes and perform the nerve conduction study.
Step 3: He will use alcohol wipes to clean the skin over certain muscles.
Step 4: He will perform the needle EMG with your muscle both relaxed and
Step 5: After the study, Dr. Sebastian will discuss the findings with you and provide any further recommendations. On rare occasions, the muscles and nerves tested may be sore after the study. This is temporary and usually resolves within a day or two. There also may be slight bruising at the site of the EMG, especially in patients on blood thinners. This will also resolve fairly quickly.
Musculoskeletal (MSK) Ultrasound
Musculoskeletal (MSK) Ultrasound is used in the office to provide real-time images of tendons, ligaments, muscles, nerves, and cartilage in the body. This painless tool can quickly identify any tears in tendons and ligaments, swelling of tissue, entrapment of nerves and other tissue abnormalities.
This diagnostic tool is very helpful when analyzing sports and orthopedic injuries (like rotator cuff tears), or chronic conditions like arthritis because it can capture the changes that occur with movement. MSK ultrasounds are performed in-office and are radiation-free.
What to Expect at Your MSK Ultrasound
During an MSK ultrasound, you will be asked to sit on the exam table or lie face up or face down depending on the location of your injury. A small amount of warm gel will be placed over the skin of the area we are examining to prevent air pockets from forming between the transducer and your skin. The sonographer will then capture images of the tissue below by gliding the transducer gently over your skin. You may be asked to move the joint being examined so that we can better analyze the ligament, muscles, or tendons involved.
The entire process is painless and takes about 20-30 minutes to complete.
