Role of High-Resolution Ultrasonography in Evaluation of Ulnar Nerve Entrapment Disorder

Document Type : Original Article

Authors

1 Department of Diagnostic Radiology, Ismailia Medical Complex, Egypt

2 Department of Diagnostic Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

3 Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Abstract

Background: Ulnar nerve entrapment (UNE) is the second most common entrapment neuropathy after the median nerve entrapment at the wrist. Electrodiagnostic studies are usually carried out to confirm the diagnosis of UNE as it is considered the gold standard diagnostic test; however, their sensitivity ranges between 49% and 86%, and specificity of 95% and 99%. Aim: The current study was conducted to determine the capability of HRUS to diagnose ulnar nerve compression.Subjects and Methods:This cross-sectional descriptive study was conducted on 44 patients with symptoms and signs of ulnar nerve compression at the elbow. The ulnar nerve was examined during both flexion and extension of the elbow using HRUS.Results: The examined ulnar nerves showed loss of echogenicity and fasciculation pattern of their fibers in about 40.9% of all included ulnar nerves. During a dynamic ultrasound study, 52.3 % of examined patients showed abnormal mobility of their ulnar nerves within the cubital fossa during elbow flexion.The mean cross-sectional area (CSA) of the ulnar nerve is greater in the extension position than in flexion along three points (5 cm proximal to the elbow, at the elbow, and 5 cm distal to it). Moreover, the mean CSA of the ulnar nerve at 5 cm proximal to the elbow, at the elbow, and 5 cm distal to the elbow with the elbow extended were 0.1025 cm2, 0.1145 cm2, and 0.1022 cm2, respectively which were significantly higher (p < /em>= 0.0001) at the level of the elbow. Conclusion: HRUS is a highly accurate, effective tool to diagnose and follow up cases of UNE syndrome.
 

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