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Tests and diagnosis
By Mayo Clinic staffTo help diagnose the extent and severity of a brachial plexus injury, you may have one or more of the following tests:
- Electromyography. This test checks the health of the nerves that help move your muscles. After small needle electrodes are inserted through your skin into a muscle, you're asked to contract that muscle. The amount of electrical activity generated provides information about how well the muscle responds when its nerves are stimulated. You may feel a little pain when the electrodes are inserted, but most people can complete the test without much discomfort.
- Nerve conduction studies. These measure how quickly impulses are conducted through a nerve. Your nerve is stimulated through a patch-like electrode attached to your skin. This stimulation can feel like an electric shock of varying intensity. Although this test can be uncomfortable, you won't have any lingering pain afterward.
- Magnetic resonance imaging (MRI). An MRI uses radio waves and a powerful magnetic field to visualize structures in your body. It often can show the extent of the damage caused by a brachial plexus injury. This test is typically used to determine if a nerve has been severed completely from your spinal cord.
- Computerized tomography (CT) myelography. A myelogram is a type of X-ray that uses a contrast material, injected during a spinal tap, to produce a detailed picture of your spinal cord and nerve roots. In CT myelography, the images are taken with a CT scanner, a device that uses X-rays to create cross sections of body tissues. This test is sometimes performed when MRIs don't provide adequate information. Your doctor may tell you to drink more water the day before the test, and you may need to stop taking certain medications for a few days before a myelogram. Side effects of the test can include headache and nausea.
References
- Brachial plexus injury (Erb's palsy). American Society for Surgery of the Hand. http://www.assh.org/Content/NavigationMenu/PatientsPublic/HandConditions/BrachialPlexusInjury/Brachial_Plexus_Inj.htm. Accessed Oct. 24, 2008.
- Burners and stingers. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=226&topcategory=Shoulder. Accessed Oct. 24, 2008.
- NINDS brachial plexus information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm. Accessed Oct. 24, 2008.
- Erb's palsy (brachial plexus birth injury). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=314&topcategory=Shoulder. Accessed Oct. 24, 2008.
- Shin AY, et al. Adult traumatic brachial plexus injuries. Journal of the American Academy of Orthopaedic Surgeons. 2005;13(6):382-396.
- Uehara DT et al. Injuries to the Shoulder Complex and Humerus. In: Tintinalli JE et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. Chapel Hill, N.C.: The McGraw-Hill Companies; 2004. http://www.accessmedicine.com/content.aspx?aID=612543&searchStr=injury+of+brachial+plexus. Accessed Nov. 11, 2008.
- McMahon PJ et al. Sports Medicine: Shoulder Neurovascular Injury. In: Skinner HB. Current Diagnosis & Treatment in Orthopedics. 4th ed. Irvine, Calif.: The McGraw-Hill Companies; 2006. http://www.accessmedicine.com/content.aspx?aID=2319261&searchStr=injury+of+brachial+plexus. Accessed Nov. 11, 2008.
