Does C5 or C6 Radiculopathy Affect the Signal Intensity of the Brachial Plexus on Magnetic Resonance Neurography?

Medical students vs general public awareness regarding disc prolapse in Jeddah

BACKGROUND

Disc herniation is a condition where tearing occurs in the outer annular layer of the intervertebral pad leading the inner gel-like material to bulge ouwards the spinal cord, due to the high load of the vertebrae. This will produce back pain and symptoms in different sites according to the level of the herniation in the vertebral column.

AIM

To compare the level of awareness regarding disc herniation among the general population and medical students in Jeddah.

METHODOLOGY

A descriptive cross-sectional study was conducted through an electronic questionnaire to assess the level of awareness regarding disc prolapse among the general population and medical students in Jeddah. The questionnaire was in the Arabic language, it was taken and validated by the previous study which took place in Taif.

RESULTS

Our studied sample involved 1026 individuals aged between 11 and 99 years, with a mean age of 34.03 ± 13.28 years old. More than half of the respondents were female (55.4%), most of them were Saudi nationals (90.1%), and most of them have received a higher education (67.7%). Results showed that 54.1% of the general population and 77.7% of medical students reported good knowledge regarding this condition.

CONCLUSION

This study revealed that the level of awareness regarding disc prolapse among the general population and medical students was poor in some respects such as: knowledge about the preventive measures, symptoms of the disease, the most common site in the spine affected by the disease, and the gold standard imaging method to diagnose this disease.

Infraspinatus muscle palsy involving suprascapular nerve, brachial plexus or cervical roots related to inflammatory or mechanical causes: Experience of 114 cases

OBJECTIVES

To report a large series of neurogenic infraspinatus muscle (ISM) palsy, in order to improve knowledge of diagnosis, diverse etiologies and care management.

METHODS

Clinical and electrodiagnostic (EDX) data for 114 cases of ISM palsy were collected over a 21-year period. Cases were attributed to 4 clinical conditions: (1) isolated suprascapular nerve mononeuropathy (n=48), (2) multiple mononeuropathies (n=33), (3) plexus lesions (n=17), and (4) cervical radiculopathy (n=16). These were related to 2 mechanisms: inflammatory (dysimmune) and mechanical.

RESULTS

Group 1 cases were younger, had the most severe ISM palsies, were mostly related to inflammatory lesions (81%) such as neuralgic amyotrophy (NA), and frequently had delayed diagnosis because disability was mild. Group 2 cases were all related to inflammatory lesions and had slightly less severe ISM palsies that were frequently hidden by winged scapula. In groups 3 and 4, ISM palsies were milder and all cases were related to mechanical lesions such as brachial plexus trauma or C4-C5-C6 radiculopathy. In these cases, deltoid and ISM palsies were equal in frequency and severity whereas biceps brachii impairment was less frequent and much milder. Deltoid palsy frequently appeared predominant as compared with ISM palsy, because upper limb elevation palsy was more disabling than external rotation palsy.

CONCLUSIONS

ISM palsy is a rare condition, often under-diagnosed and misidentified. The 4 main conditions of ISM palsy may be recognized by careful clinical, EDX and other examinations when necessary. Analysis of the present series highlights some clinical and EDX points that should help non-specialist and even specialist clinicians who are faced with this rare condition, to distinguish mechanical and inflammatory causes, and thus adapt patient management accordingly.