Role of dynamic sonography in ulnar nerve entrapment at elbow

Abstract

Background: High-resolution ultrasound (HRUS) is a rapidly developing technology that is gaining popularity for the evaluation of the ulnar nerve. Objective: To evaluate the role of dynamic HRUS for the detection of different abnormalities of ulnar nerve entrapment at the elbow. Patients and Methods: Sixty-two elbows divided into 23 elbows with symptomatic and sonographic findings (symptomatic group), 39 elbows as a control group, which were further subdivided into 24 which were clinically and sonographically free (control group), and 15 subjects as a case nonmanifest group who were clinically free, but has sonographic findings (asymptomatic UNE group), were studied. The ulnar nerve cross-sectional area (CSA) was measured at the Guyon canal, mid-forearm, and maximal swelling (MS) point around the elbow. We assessed also the flattening ratio at the elbow by measuring the widest transverse and anteroposterior diameters during elbow extension and flexion. Results: There was a statistically significant difference of the cross-sectional area and flattening ratio of the ulnar nerve at the elbow during extension and flexion between the three groups (symptomatic, case nonmanifest, and healthy control elbows) (P value = 0.05). Conclusion: Dynamic HRUS is a highly accurate, sensitive diagnostic modality for the ulnar nerve entrapment syndrome at the elbow.

Diagnostic efficiency of conventional ultrasound, shear wave elastography, and superb microvascular imaging in evaluating ulnar neuropathy at the elbow

“…CSA is an internationally accepted ultrasound parameter, and the ultrasonography features observed in our investigation were consistent with previous studies 3,22,23 . The UN CSA cutoff values in earlier research ranged from 10 to 10.5 mm 2 5 .…”

“…CSA is an internationally accepted ultrasound parameter, and the ultrasonography features observed in our investigation were consistent with previous studies. 3,22,23 The UN CSA cutoff values in earlier research ranged from 10 to 10.5 mm 2 . 5 In our study, the optimal cutoff value for CSA max provided high sensitivity and specificity, which was in agreement with the findings of Ali et al 22 However, the sensitivity and specificity of CSA found in the study of Pelosi et al 24 was significantly lower than the results of our study.…”

Future Considerations in the Diagnosis and Treatment of Compressive Neuropathies of the Upper Extremity

“…2 ). 14 , 15 , 16 , 17

Figure 1 Ultrasound images demonstrating a normal median nerve at the wrist with a CSA of 11 mm 2 ( A ) and a normal ulnar nerve at the elbow with a CSA of 7 mm 2 ( B ). Ultrasound images courtesy of and copyright protected by Dale S. Colorado, DO, MPH and David M. Brogan, MD, MSc – used with permission.

…”