R. Dimova 1, E. Titianova 1,3, S. Karakaneva 1, I. Daskalova 2
1 Clinic of Functional Diagnostics of Nervous System,
2 Clinic of Endocrinology, Military Medical Academy – Sofia, 3Faculty of Medicine, Sofia University St. Kliment Ohridski – Sofia, Bulgaria

Objective: To summarize our experience in parallel electromyographic (EMG) and multimodal ultrasound imaging studies of calf muscle structure and function in patients with different neurological and non-neurological disorders.

Material and Methods: Different types of triceps surae (TS) muscle disturbances due to traumatic injury, genetic disorders, peripheral neuropathy, chronic spastic hemiparesis, venous pathology and combined hemiparesis after cervical and lumbar spinal surgery were evaluated by EMG and electroneurography. The findings were juxtaposed to corresponding images obtained by simultaneous multimodal 2D/3D/4D myosonography in rest, during maximal plantar flexion and electrical stimulation. The results were compared to EMG findings and myosonograms of healthy persons.

Results: Typical EMG findings and calf muscle architectonics were found in relation to the location, type and severity of TS lesions, muscle fibers contractility, degree of muscle atrophy, fat tissue infiltration, fibrosis and vascularisation. Both methods give the opportunity to evaluate possible discrepancy between peripheral nerve damage and associated functional muscle changes.

Discussion: The combined use of EMG and myosonology is superior to the single application of each of both methods providing additional information about the structural and functional changes of calf muscles in normal and pathological conditions.

Key words: electromyography, myosonology, triceps surae muscle.

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