Revisiting traumatic brachial plexus injury—Imaging correlation of modified Sunderland classification and beyond

Abstract

Bourgeoning vehicular accidents is leading to a rise in the traumatic brachial plexus injuries (TBPIs). Brachial plexus is a cardinal neural plexus catering to the sensory-motor function of the upper limb. Thus, prompt diagnosis and early management are must in case of TBPIs. Although no single modality is a universal gold standard across the full spectrum of TBPIs, Magnetic resonance imaging (MRI) forms the corner stone of imaging evaluation. Even with excellent resolution, clinching the diagnosis is an uphill task, as already complicated anatomy, becomes scrambled following trauma. Imaging plays a crucial role in management, as it not only diagnose TBPIs, but also accurately identify the site of injury and stratify it. Grading of TBPIs have bearing of management decisions and an accurate stratification, leads to significant reduction in morbidity. Modified Sunderland Classification is widespread accepted classification which can be correlated on MRI. Through this manuscript, the author has tried to simplify this correlation and provide an image guide for imagers along with a table summarizing the important take home points at last.