Diagnostic value of high-resolution sonography in ulnar neuropathy at the elbow

Beekman, Roy; Schoemaker, Marinus C.; Plas, J; Berg, Leonard H van den; Franssen, Hessel; Wokke, John H. J.; Uitdehaag, Bernard M. J.; Visser, Leo H.

doi:10.1212/01.wnl.0000113733.62689.0d

Cited by 216 publications

(214 citation statements)

References 17 publications

Supporting

Mentioning

191

Contrasting

Unclassified

Order By: Relevance

“…These changes can be quantified by measuring nerve size parameters, such as the cross-sectional area (CSA) of the nerve. The increase of CSA of the involved nerve allows precise localization in entrapment neuropathies and peripheral nerve tumors [1][2][3][4]. Moreover, enlargements of multiple nerves in acquired and hereditary polyneuropathies are also described [5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Neurosonography provides a reliable diagnosis and localization in entrapment neuropathies, traumatic peripheral nerve injuries and tumors of the peripheral nerves, and it has become a useful supplementary tool for electrodiagnostic studies in these conditions [1][2][3][4]. Characteristic nerve size changes in polyneuropathies have been reported as well [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High-Resolution Ultrasonography of Peripheral Nerves: Measurements on 14 Nerve Segments in 56 Healthy Subjects and Reliability Assessments

Boehm¹,

Scheidl

Bereczki

et al. 2014

Ultraschall in Med

View full text Add to dashboard Cite

Purpose: The aim of this study was to assess different aspects of reliability in high resolution ultrasonography (HRUS) of the peripheral nerves and to establish reference values for the most frequently examined nerve segments. Materials and Methods:A nerve size parameter, the cross-sectional area (CSA) of the C5, C6 and C7 cervical roots, the median, ulnar, radial, superficial radial, peroneal, tibial, and the sural nerves was measured using HRUS at altogether 14 predefined anatomical sites in two different cohorts of healthy subjects (n=56), and the inter-rater, intra-rater and interequipment reliability of measurements was assessed.Results: Mean CSA of the 14 nerve segments ranged from 2 to 10 mm 2 . Intra-rater, inter-rater and inter-equipment reliability was high with intraclass correlation coefficients of 0.93, 0.98, and 0.86, respectively. CSA values showed no consistent correlation with age, height, and body weight, but males had significantly larger values than females for nerve segments on the arm after correcting for age, weight and height in multivariate analysis. CSA values did not differ when two independent cohorts were compared. Conclusion:Peripheral nerve ultrasonography is a reliable and reproducible diagnostic method in the hands of experienced examiners. Normal values for several upper and lower extremity nerves are provided by our study.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High-Resolution Ultrasonography of Peripheral Nerves: Measurements on 14 Nerve Segments in 56 Healthy Subjects and Reliability Assessments

Boehm¹,

Scheidl

Bereczki

et al. 2014

Ultraschall in Med

View full text Add to dashboard Cite

show abstract

“…Sonography and short-segment NCS are, therefore, additional instruments to localize the lesion in patients with UNE. 4 When analyzing the results of short-segment NCS, it is important to determine the upper limits of normal conduction times and amplitude changes over each 2-cm segment separately. Amplitude reduction or latency change differs over the various 2-cm segments across the elbow.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in the patients with nonlocalizing electrodiagnostic signs, clinical follow-up and sometimes magnetic resonance imaging of the brachial plexus or cervical spine were used to exclude conditions mimicking UNE (lower brachial plexopathy, radiculopathy, and ulnar neuropathy at the wrist). 4 Patients with a history of ulnar nerve surgery, acute traumatic origin of UNE, a history of polyneuropathy or genetically proven hereditary neuropathy with liability to pressure palsies, or signs of polyneuropathy were excluded from the study.…”

Section: Diagnosis Of Unementioning

confidence: 99%

See 1 more Smart Citation

Short‐segment nerve conduction studies in ulnar neuropathy at the elbow

2005

View full text Add to dashboard Cite

The aim of the study was to assess the diagnostic value of short-segment nerve conduction studies (NCS) at 2-cm intervals from 4 cm above to 4 cm below the medial epicondyle in a large group of patients with ulnar neuropathy at the elbow (UNE). Furthermore, we wanted to compare electrodiagnostic and clinical findings. We evaluated 73 arms in 70 patients with UNE and observed the following abnormalities on short-segment NCS: focal conduction block (CB) in 1, focal CB with increased latency change in 34, and increased latency change alone in 25. Short-segment NCS had an additional localizing value in 28 arms of the 37 patients (76%) with motor conduction velocity (MCV) slowing across the elbow only or with nonlocalizing electrodiagnostic findings. The lesion was located above the elbow in 32 arms (53%), at the epicondyle in 16 arms (27%), and below the epicondyle in 12 (20%) of the 60 arms with focal CB or increased latency change on short-segment NCS. Patients with CB on routine and short-segment NCS had muscle weakness significantly more often than patients without CB. Thus, short-segment NCS are useful in localizing the lesion in patients with UNE and CB on routine NCS and have additional diagnostic value in patients with MCV slowing across the elbow or with nonlocalizing signs on routine nerve conduction studies. We recommend its use in all patients in whom UNE is suspected.

show abstract

Treatment for ulnar neuropathy at the elbow

Caliandro

Torre

Padua

et al. 2011

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

The available evidence is not sufficient to identify the best treatment for idiopathic ulnar neuropathy at the elbow on the basis of clinical, neurophysiological and imaging characteristics. We do not know when to treat a patient conservatively or surgically. However, the results of our meta-analysis suggest that simple decompression and decompression with transposition are equally effective in idiopathic ulnar neuropathy at the elbow, including when the nerve impairment is severe. In mild cases, evidence from one small randomised controlled trial of conservative treatment showed that information on movements or positions to avoid may reduce subjective discomfort.

show abstract

Diagnostic value of high-resolution sonography in ulnar neuropathy at the elbow

Abstract: High-resolution sonography is an accurate and easily applied test for the diagnosis of UNE. The authors recommend its use in addition to electrodiagnostic studies because it improves the reliability of the diagnosis of UNE.

Cited by 216 publications

References 17 publications

High-Resolution Ultrasonography of Peripheral Nerves: Measurements on 14 Nerve Segments in 56 Healthy Subjects and Reliability Assessments

High-Resolution Ultrasonography of Peripheral Nerves: Measurements on 14 Nerve Segments in 56 Healthy Subjects and Reliability Assessments

Short‐segment nerve conduction studies in ulnar neuropathy at the elbow

Treatment for ulnar neuropathy at the elbow

Contact Info

Product

Resources

About