Diagnosing Brachial Plexus Injuries

NYU Langone orthopedists collaborate to diagnose and treat adults and children with brachial plexus injuries. A brachial plexus injury affects the network of nerves that extends from the base of the neck through the shoulders and arms, causing symptoms such as pain, numbness, and loss of movement. These injuries often occur as the result of a car accident or other traumas such as injuries to children during birth. Rarely, a syndrome called brachial neuritis causes pain and weakness similar to trauma-related brachial plexus injuries.  

At NYU Langone’s Center for Brachial Plexus Injuries, our team of specialists, including orthopedic surgeons, hand and wrist surgeons, physical therapists, occupational therapists, and neurologists, can diagnose brachial plexus injuries with a comprehensive physical examination, imaging, and other diagnostic tests.

If the injury is causing debilitating pain, loss of movement, or paralysis, seek immediate care at an emergency department. Injuries that are not as severe can be examined by your doctor at their office.

Physical Exam

To diagnose a brachial plexus injury, your doctor asks about your symptoms and performs a thorough physical examination of your neck, shoulders, arms, and hands. They may ask you to perform movements to assess your strength and range of motion. They also review your medical history and ask about previous injuries and other conditions to better understand the cause and nature of your symptoms. Our physical therapists also assess your strength, motor skills, and reflexes to ensure the most accurate diagnosis. Additional appointments are scheduled if needed, including a neurology exam and occupational therapy assessment.

Imaging Exams

Your doctor may recommend one or more of the following imaging exams to provide a more detailed picture of the injury.

X-Rays

X-rays use high-energy beams of light to create pictures of the bones in the neck and shoulder. X-ray images can determine whether there is an accompanying fracture or dislocation that occurred along with the brachial plexus injury, and help your doctor decide on the most appropriate treatment plan.

MRI Scan

Your doctor may recommend an MRI scan, which uses magnetic fields to take three-dimensional images of soft tissues inside the body. Detailed images of the brachial plexus can help your doctor identify the cause of your symptoms.

Electromyography

Your doctor may perform an electromyogram (EMG) 6 to 12 weeks after your initial diagnosis, and then repeat it every 3 months to gauge your recovery and provide a baseline comparison for follow-up tests that take place after your treatment. The neurologist inserts a tiny needle electrode through the skin and into the muscle to measure the electricity produced by your muscle cells when they are activated by a nerve impulse.

Nerve Conduction Study

A nerve conduction study is used after three months to measure your recovery and determine a baseline for additional testing. During this test, your neurologist measures how long it takes for an electrical impulse to travel from your brachial plexus at the base of your neck through your shoulder and arm. Several areas are tested, and a slow response likely indicates a compressed nerve.