An ultrasonographic and electromyographic evaluation of jumping stump possibly due to a neuroma in a patient with transradial amputation: A case report

Article type: Case Report

Authors: Giray, Esra^{a; *} | Atalay, Kardelen Gencer^a | Şirazi, Serdar^b | Alp, Mehmet^b | Yagci, Ilker^a

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey | [b] Orthopaedic Surgery Clinic, Istanbul Safak Hospital, Istanbul, Turkey

Correspondence: [*] Corresponding author: Esra Giray, Physical Medicine and Rehabilitation Specialist, Department of Physical Medicine and Rehabilitation, Marmara University Medical School, Fevzi Çakmak Mahallesi, Tepe Sokak no. 41, Üst Kaynarca, Pendik, Istanbul, Turkey. Tel.: +90 216 657 06 06; Extension: 1611; E-mails: girayesra@hotmail.com and esra.giray@marmara.edu.tr.

Abstract: BACKGROUND AND OBJECTIVE: Jumping stump is an uncommon movement disorder characterized by involuntary movements and severe neuropathic pain in the stump. The pathophysiology and etiology of this phenomenon have not yet been clearly elucidated, and unfortunately, no proven treatment with successful recovery exists. This report aims to describe a severe painful jumping stump, possibly due to neuromas, in a traumatic transradial amputee. MATERIALS AND METHOD: We performed ultrasound examination of the painful stump depicted neuroma. Electromyographic evaluation of the stump revealed arrhythmic motor unit action potentials (MUAPs) with normal duration and amplitude; other movement disorders, such as myokymia and fasciculations, were excluded. Ultrasound should be preferred to magnetic resonance imaging (MRI) for evaluation of stumps in patients with painful stump because MRI may not be helpful due to motion artefacts. The involuntary movements ceased after surgical excision of the neuroma following failure of conservative treatments. CONCLUSION: This report confirms that neuromas are clearly associated with jumping stump. Ultrasonographic and electromyographic assessments are necessary to reveal the features of this pathology for treatment planning.

Keywords: Amputee, electromyography, jumping stump, movement disorder, pain, peripherally-induced movement disorder, stump, neuroma

DOI: 10.3233/BMR-191645

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 33-37, 2021