Corticosteroid injection in patients with ulnar neuropathy at the elbow: A randomized, double‐blind, placebo‐controlled trial

Abstract

We could not demonstrate a positive effect of ultrasound-guided corticosteroid injection in UNE compared with placebo. Favorable outcomes may be attributed to the natural course of UNE or the effect of patient education.

Ultrasound-guided Cubital Tunnel Injection: Description of Technique and Accuracy in a Cadaver Model

“…The only two clinical studies that have used ultrasound 6,9 placed the injections subcutaneously. While it can be argued that this small distance may be irrelevant, it stands to reason that the closer the anti-inflammatory injection can be to the nerve, the more surface area is exposed to the medication.…”

“…The width of the UN varies by 50% 1 depending upon elbow flexion, so for patient safety arm positioning cannot be overstated. The need for a reliable technique is based upon the fact that there is no consistency between the five clinical trials [6][7][8][9][10] involving injections of the UN at the elbow. Three variables are never standardized: Position of the arm, depth of the injection, and use of ultrasonography.…”

Why do local corticosteroid injections work in carpal tunnel syndrome, But not in ulnar neuropathy at the elbow?

“…They had commented on a study by vanVeen et al and the role of corticosteroid injections for treatment of carpal tunnel syndrome. 2 However, we are not at all convinced that exact targeting of the median nerve in carpal tunnel syndrome is not necessary. The authors claimed that medication delivered close to the carpal tunnel suffices.…”

Comment on corticosteroid injection in patients with ulnar neuropathy at the elbow: A randomized, double‐blind, placebo‐controlled trial

“…I read with interest the article by van Veen, et.al. published in the September 2015 issue . It is an excellent article that reports evaluation of the effect of ultrasound‐guided corticosteroid injections in patients with ulnar neuropathy around the elbow.…”

“…As shown in Figures 1 and 2 of the study by van Veen et al, the needle was placed near the thickest part of the ulnar nerve in a longitudinal plane. I think this plane corresponds to the distal portion of the cubital tunnel between the flexor carpi ulnaris and flexor digitorum superficialis.…”