Posterior interosseous nerve of the elbow: normal appearances simulating entrapment.

OBJECTIVE In our clinical practice, we have noted a caliber change of the posterior interosseous nerve (PIN) at the elbow as seen in the long axis on sonography simulating nerve entrapment. The objective of this study was to characterize the PIN using sonography in asymptomatic individuals. METHODS Our study retrospectively characterized the PIN in 50 elbows of 47 asymptomatic patients with sonography. Measurements of the PIN in a short-axis cross section using the circumferential trace technique and the anteroposterior (AP) dimension in the long axis were made proximal, at, and distal to the arcade of Frohse. RESULTS There was reduction of the AP dimension of the PIN distal to the arcade of Frohse when compared with the measurements at the arcade of Frohse and proximal to the arcade (P < .0001); however, there was no significant difference between the cross-sectional area of the PIN at all 3 levels (P = .59). CONCLUSIONS The PIN normally flattens as it enters into the supinator muscle without a notable change in the cross-sectional area. This appearance should not be misinterpreted as nerve entrapment when imaged in the long axis.