Assessment of the role of ultrasonography in diagnosis of leprosy in patients with ulnar nerve involvement

Abstract

Aims: For long, the clinical investigation of leprosy with neural involvement is by palpation of the nerve for thickness and tenderness. This highly subjective method is supported only by nerve biopsy which causes even more loss of the nerve and adds to the deformity. The aim of this study was to determine the usefulness of ultrasonography in assessing early symptoms, extent and site of the nerve involvement and to evaluate the prognosis or likely progression of nerve damage in different clinical types of leprosy patients and compare it with routine clinical investigations. Methods: General clinical examination was done on all leprosy patients and ultrasonography of the ulnar nerve was done via Philips Enviser 15MHz linear probe. The data collected was interpreted statistically and analyzed by using the standard tests to ascertain the clinical relevance of the present study. Result: Ultrasonography was proved to be significant in assessing the early symptoms, extent and site of nerve involvement in different clinical types of leprosy patients. It enables tracking those signs of leprosy which cannot be assessed on clinical examination and thus supplements clinical examination in the diagnosis of leprosy. It evaluates the prognosis during treatment or the likely progression of nerve damage in leprosy patients. Conclusion: This study supports the inclusion of ultrasonography as a routine diagnostic procedure in leprosy, so as to facilitate an early diagnosis and early initiation of treatment. This can help in preventing progression of the disease and its complications. Ultrasonography enables rapid and accurate imaging and is cost effective, thus confirming the convenience and compliance of the patient.