What causes Stocking glove sign in extremities on imaging?
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Answer:
Stocking glove sign refers to a distribution pattern of peripheral neuropathy seen on nerve conduction studies, characterized by sensory and motor deficits in a distal symmetric pattern affecting hands and feet; it is also described in radiology for peripheral subcutaneous emphysema or edema confined to the hands and feet on plain radiographs or CT, associated with conditions causing distal extremity involvement such as severe peripheral neuropathies (e.g., diabetic neuropathy, Guillain-Barré syndrome), trauma, or vascular compromise.
Why is it called so?
The name derives from the clinical resemblance to wearing stockings on the feet and gloves on the hands, reflecting the characteristic distal symmetric involvement of the extremities in a length-dependent manner that spares more proximal regions.
Pathophysiology
In neuropathy, the sign develops due to length-dependent axonal degeneration where longer nerves to the distal extremities (hands and feet) are affected first by metabolic, toxic, or inflammatory insults, leading to impaired nerve conduction; for subcutaneous emphysema or edema, it results from localized interstitial air or fluid accumulation in distal tissues due to trauma, infection, or lymphatic obstruction, creating a peripheral distribution limited to acral regions.
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