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When a patient comes to clinic being referred for brachial plexus injury, our diagnosis is based on three important tests. The first one being the physical examination. The way brachial plexus injuries present is usually quite typical. The onset is usually immediate and severe. The types of patterns of injury are classical and easily recognized. And the examination is a thorough examination of the muscles, strength and sensation of the upper extremity. The second piece of this is if we determine that the muscles are completely paralyzed and not recovering on their own, we will often get an MRI or imaging of the cervical spine and brachial plexus to determine the severity of the injury. This sometimes requires a myelogram, which is a CAT scan where diodes injected to the spine. Often at centers that have a high quality MRI, the MRI itself would be sufficient to delineate the severity and extent of the injury. The third piece of the test is the EMG or electromyography. This is a test that usually a neurologist is performing that involves placing needles into the muscles and determining whether their paralysis is complete or there is any signs of recovery of function.
