Nerve ultrasound reliability of upper limbs: Effects of examiner training

Rocio Garcia-Santibanez, Alexander R. Dietz, Robert C. Bucelli, Craig M. Zaidman

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Introduction: Duration of training to reliably measure nerve cross-sectional area with ultrasound is unknown. Methods: A retrospective review was performed of ultrasound data, acquired and recorded by 2 examiners—an expert and either a trainee with 2 months (novice) or a trainee with 12 months (experienced) of experience. Data on median, ulnar, and radial nerves were reviewed for 42 patients. Results: Interrater reliability was good and varied most with nerve site but little with experience. Coefficient of variation (CoV) range was 9.33%–22.5%. Intraclass correlation coefficient (ICC) was good to excellent (0.65–95) except ulnar nerve-wrist/forearm and radial nerve-humerus (ICC = 0.39–0.59). Interrater differences did not vary with nerve size or body mass index. Expert–novice and expert–experienced interrater differences and CoV were similar. The ulnar nerve-wrist expert–novice interrater difference decreased with time (rs = −0.68, P = 0.001). Discussion: A trainee with at least 2 months of experience can reliably measure upper limb nerves. Reliability varies by nerve and location and slightly improves with time. Muscle Nerve 57: 189–192, 2018.

Original languageEnglish
Pages (from-to)189-192
Number of pages4
JournalMuscle and Nerve
Issue number2
StatePublished - Feb 2018


  • nerve
  • reliability
  • sonography
  • training
  • ultrasound
  • upper limb


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