Comparison of neural thickening detected by clinical palpation and ultrasonography in patients from the Brazilian Amazon.

Authors

Brenda Ramos, Camilo Ramos, Thaila Lima, Marília Xavier

Published in

Scientific reports. Jul 08, 2026. Epub Jul 08, 2026.

Abstract

Ultrasonography has increasingly been used to support the diagnosis and follow-up of peripheral neuropathy associated with leprosy. This study aims to compare and correlate clinical findings based on the Simplified Neurological Assessment (SNA), a protocol recommended by the Brazilian Ministry of Health, particularly nerve palpation for the assessment of neural thickening, with ultrasonographic findings of the ulnar and median nerves in patients diagnosed with leprosy. A total of 50 patients were clinically evaluated and underwent high-resolution nerve ultrasonography. The correlation between clinical findings, particularly clinical nerve palpation, and sonographic findings was assessed using the Kappa coefficient, and discordance between the methods was additionally evaluated using the McNemar test. A weak agreement (Kappa = 0.12; 95% CI: 0.02-0.26) was found between the two methods used to identify neural thickening-clinical nerve palpation and ultrasonographic CSA evaluation. In addition, analysis of discordance between clinical palpation and ultrasonographic CSA evaluation demonstrated a statistically significant difference across all evaluated nerves (p < 0.01), favoring ultrasonography for the detection of neural thickening. These findings raise important questions regarding the sensitivity of clinical nerve palpation for the assessment of nerve thickening, and the potential role of ultrasonography as a complementary and more objective diagnostic tool in the context of leprosy neuropathy. Our results highlight the relevance of incorporating ultrasonographic evaluation into leprosy care protocols to enhance early detection and improve patient outcomes.

PMID:
42420470
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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