AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...

The Diagnostic Value of Ultrasound in Cubital Tunnel Syndrome
Institution where the work was prepared: Wake Forest University School of Medicine, Winston-Salem, NC, USA
G.D. Chloros, MD; Ethan R. Wiesler; Michael S. Cartwright; Hae W. Shin; Francis O. Walker; Wake Forest University School of Medicine
Purpose:
Cubital Tunnel Syndrome (CuTS) is traditionally evaluated by a thorough history, physical examination and nerve conduction studies. However, it encompasses
a spectrum of clinical findings making its diagnosis difficult or even impossible solely on clinical grounds and/or NCS. The purpose of this study is to document
the ultrasonographic measurement differences in ulnar nerve size between patients with UNE and controls and to correlate these findings with clinical
examination findings and NCS abnormalities, thereby testing the validity of ultrasound (US) as an additional diagnostic modality for CuTS.
Methods:
Twelve elbows in 12 patients (6 males and 6 females, mean age = 51 years, range, 16 - 68) with symptoms, clinical examination and NCS findings consistent
with CuTS underwent US of the ulnar nerve at the elbow. Patients were excluded if they had history of polyneuropathy, acute trauma involving the upper
extremity, any kind of trauma in the region of the elbow (including previous surgery), or brachial plexus injury. The control group consisted of 60 elbows of
30 normal volunteers (19 females, 11 males, mean age = 30 years, range 24 - 50) that also underwent ultrasound. Maximal cross-sectional areas (CSA) were
measured and compared for the two groups and correlation analysis was performed between nerve size and NCS findings.
Results:
The average CSA of the ulnar nerve was 6.5 mm2 (range: 5.0 to 10.0, SD = 0.09) in the control group, whereas in the CuTS group was 17.0 mm2 (range: 12.0
to 37.0, SD = 8.0), p