{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:33:43Z","timestamp":1786235623727,"version":"build-2736575974"},"reference-count":52,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Radial nerve palsy typically presents as wrist drop due to nerve compression, with conventional management often yielding prolonged recovery. We report a case where ultrasound-guided hydrodissection (HD) with 5% dextrose in water (D5W) achieved immediate functional restoration, suggesting neurapraxia as the underlying pathology. Case Presentation: A 54-year-old diabetic female presented with acute left wrist drop without trauma. Examination confirmed radial nerve palsy (MRC grade 0 wrist extension), while radiographs ruled out structural causes. Ultrasound revealed fascicular swelling at the spiral groove. Under real-time guidance, 50 mL D5W (no local anesthetic) was injected to hydrodissect the radial nerve. Immediate post-procedure assessment showed restored wrist extension (medical research council (MRC) grade 4+). At one- and three-month follow-ups, the patient maintained complete resolution of symptoms and normal function. Conclusions: This case highlights two key findings: (1) HD with D5W can serve as both a diagnostic tool (confirming reversible neurapraxia through immediate response) and therapeutic intervention, and (2) early HD may circumvent prolonged disability associated with conservative management. The absence of electrodiagnostic studies limits objective severity assessment, though ultrasound localized the lesion. While promising, these observations require validation through controlled trials comparing HD to standard care, particularly in diabetic patients with heightened compression susceptibility. Technical considerations\u2014including optimal injectate volume and the role of adjuvant therapies\u2014warrant further investigation. US-guided HD with D5W emerges as a minimally invasive, surgery-sparing option for acute compressive radial neuropathies, with potential to redefine treatment paradigms when applied at symptom onset.<\/jats:p>","DOI":"10.3390\/diagnostics15151880","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T07:57:24Z","timestamp":1753689444000},"page":"1880","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Confirming the Presence of Neurapraxia and Its Potential for Immediate Reversal by Novel Diagnostic and Therapeutic Ultrasound-Guided Hydrodissection Using 5% Dextrose in Water Without Local Anesthetics: Application in a Case of Acute Radial Nerve Palsy"],"prefix":"10.3390","volume":"15","author":[{"given":"Ho Won","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Hallym University Gangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-9856","authenticated-orcid":false,"given":"Jihyo","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hallym University Gangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1207-348X","authenticated-orcid":false,"given":"Chanwool","family":"Park","sequence":"additional","affiliation":[{"name":"IncheonTerminal Orthopedics, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjae","family":"Lee","sequence":"additional","affiliation":[{"name":"IncheonTerminal Orthopedics, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8746-3718","authenticated-orcid":false,"given":"Yonghyun","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hallym University Gangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea"},{"name":"IncheonTerminal Orthopedics, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"International Association of Regenerative Medicine, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"MSKUS, 1035 E. Vista Way #128, Vista, CA 92084, USA"},{"name":"The Board of Clinical Research, The International Association of Musculoskeletal Medicine, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeui-Seok","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyemi","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Bio Plastic Surgery Clinic, Seoul 03186, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Sae Yonsei Rehabilitation Clinic, Seoul 03186, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehyun","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chungdammadi Neurosurgery Clinic, Seoul 03186, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhyuk","family":"Ann","sequence":"additional","affiliation":[{"name":"IncheonTerminal Orthopedics, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8646-0918","authenticated-orcid":false,"given":"Daniel Chiung-Jui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Tempo Regeneration Center for Musicians, Tainan 700, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6722-0268","authenticated-orcid":false,"given":"Teinny","family":"Suryadi","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Synergy Clinic, Jakarta 11510, Indonesia"},{"name":"Department of Physical Medicine and Rehabilitation, Hermina Podomoro Hospital, Jakarta 14350, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2346-2326","authenticated-orcid":false,"given":"Keneath Dean","family":"Reeves","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Private Practice, Kansas City, MO 64132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-829X","authenticated-orcid":false,"given":"King Hei Stanley","family":"Lam","sequence":"additional","affiliation":[{"name":"The Board of Clinical Research, The International Association of Musculoskeletal Medicine, Kowloon, Hong Kong"},{"name":"Faculty of Medicine, The University of Hong Kong, Hong Kong"},{"name":"Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong"},{"name":"The Board of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1302\/0301-620X.87B12.16132","article-title":"Radial nerve palsy associated with fractures of the shaft of the humerus: A systematic review","volume":"87","author":"Shao","year":"2005","journal-title":"J. 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