"Why Do I Feel This Pain?" B-Mode and Power Doppler Ultrasound Found the Answer: A Neurovascular Conflict

Neurovascular conflict (NC) represents a rare condition in which a nerve can be transiently compressed by vascular pulsations. This circumstance might cause pain and motor deficit. This particular condition is usually associated with anatomical variation of the involved vessels and/or nerves. Some reports describe nerve palsies due to vessel abnormalities caused by trauma (i.e., aneurysm or pseudoaneurysm), but the cases due to anatomical variations without a history of trauma are rarely described. In cases of NC, clinical evaluation is extremely important because it allows clinicians to identify neuropathy signs, and electrophysiology represents the gold standard for the assessment of nerve function, allowing doctors to confirm diagnostic suspicions. Unfortunately, NC may be susceptible to misunderstanding, and sometimes diagnosis is not possible. Because of the ontogenetic features of NC, morphological evaluation could be considered to detect the abnormalities underlying the conflict, and it may be very helpful for the diagnosis. Among the techniques, ultrasound (US), with its ability to show patient anatomy, represents a very useful tool from diagnosis to rehabilitation treatment. This approach can assess nerve and vessels and, hence, may be a potential candidate to support the diagnosis of NC.