5. Segmental changes in ulnar nerve ultrasound across the elbow and their pathophysiological significance in ulnar neuropathy

2014 ◽  
Vol 125 (4) ◽  
pp. e2
Author(s):  
Neil G. Simon ◽  
Jeffrey W. Ralph ◽  
Ann Poncelet ◽  
John W. Engstrom ◽  
Cynthia Chin ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Ulnar Neuropathy ◽  
Nerve Ultrasound

001 Ulnar neuropathy with abnormal non-localising electrophysiology: clinical, electrophysiological and ultrasound findings

2018 ◽  
Vol 89 (6) ◽  
pp. A2.1-A2
Author(s):  
Luciana Pelosi ◽  
Dominic Ming Yin Tse ◽  
Eoin Mulroy ◽  
Andrew M Chancellor ◽  
Michael R Boland
Keyword(s):  
Ulnar Nerve ◽  
Significant Role ◽  
Diagnostic Tests ◽  
Ulnar Neuropathy ◽  
Axonal Loss ◽  
Nerve Ultrasound ◽  
Causative Mechanism ◽  
Ultrasound Findings ◽  
Significant Disability

IntroductionUlnar neuropathy with abnormal non-localising electrophysiology (NL-UN) is often associated with significant disability that is difficult to manage due to the absence of anatomically defining studies. We studied demographic, clinical and electrophysiological characteristics of NL-UN and used ultrasound in order to assist with classification and to examine the utility of ultrasound over and above the conventional electro-diagnostic approach.MethodNL-UNs were identified from 113 consecutive referrals to a single neurophysiologist with suspected ulnar neuropathy. All received systematic electro-diagnostic tests and ulnar nerve ultrasound. NL-UN severity was graded using clinical and electrophysiological scales.ResultsIn 64 of 113 referrals, an ulnar mononeuropathy was confirmed by electrophysiology. Sixteen of these 64 (25%) had NL-UN, predominantly males (14 out of 16 patients) with severe or moderately severe clinical and electrophysiological ratings in 81%. Ultrasound showed focal ulnar neuropathy at the elbow (UNE) in 13 out of 16, and diffuse ulnar nerve abnormality in three, and identified a likely or possible causative mechanism in 11 UNEs.ConclusionA quarter of ulnar neuropathies, as demonstrated by abnormal electrophysiology, were NL-UN, of heterogeneous aetiology; the majority were males with significant disability and axonal loss. Ultrasound had a significant role in localization and classification of NL-UN that facilitated management.

scholarly journals 121 Diabetic ulnar neuropathy with non-localizing electrophysiology: a nerve ultrasound study

2019 ◽  
Vol 90 (e7) ◽  
pp. A39.2-A39
Author(s):  
Luciana Pelosi ◽  
Lance Blumhardt ◽  
Vivien Yong
Keyword(s):  
Ulnar Nerve ◽  
Small Sample ◽  
Ulnar Neuropathy ◽  
Focal Lesion ◽  
Diabetic Patients ◽  
List Type ◽  
Nerve Ultrasound ◽  
Focal Lesions ◽  
Ultrasound Study ◽  
Ultrasound Findings

IntroductionThe classification and management of diabetic ulnar mono-neuropathy with non-localizing electrophysiology (NL-UN) is challenging, as this could be due to a focal axonal lesion at the elbow that may require surgery or, be part of the mono-neuritis multiplex spectrum of diabetic neuropathy. The distinction cannot be made by clinical examination and electrophysiology.We investigated the value of nerve ultrasound in this situation.MethodsWe analysed ulnar nerve ultrasound in 9 consecutive diabetic patients (5 males, mean age 65.4 years) with 12 NL-UN affected nerves. The ulnar neuropathy was clinically and electrophysiologically severe in 9 nerves and moderate in 3.ResultsUltrasound showed diffuse ulnar nerve abnormality in 9 nerves (75%) and focal nerve abnormalities at the elbow in 3 (25%)ConclusionsThe majority of NL-UNs in this small sample of patients with diabetes were not due to focal lesions at the elbow. This is in contrast with the nerve ultrasound findings in non-diabetic patients with NL-UN, which almost invariably show a focal lesion at the elbow (Pelosi et al, 2018), and confirms that the pathophysiology of ulnar mono-neuropathy is different and more complex in diabetes.Ultrasound appears to be a useful tool to classify NL-UN in the patient with diabetes and larger studies are indicated.ReferencesPelosi, et al. Ulnar neuropathy with abnormal non-localizing electrophysiology: Clinical, electrophysiological and ultrasound findings. Clin Neurophysiol 2018, 129:2155–2161.

A CASE REPORT OF ACUTE CUBITAL TUNNEL SYNDROME CAUSED BY VENOUS THROMBOSIS

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 137-139 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiko Saito
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Nerve Compression ◽  
Ulnar Neuropathy ◽  
Cubital Tunnel ◽  
Ulnar Nerve Compression ◽  
Compression Neuropathy ◽  
Tunnel Syndrome

Compression neuropathy of the ulnar nerve at the elbow is well-recognised as cubital tunnel syndrome (CuTS). Many causes of ulnar neuropathy at the elbow have been identified. A previously unreported finding of ulnar nerve compression in the cubital tunnel caused by a thrombosed proximal ulnar recurrent artery vena comitans is described.

scholarly journals ELBOW ULNAR NEUROPATHY: TREATMENT BY ANTERIOR TRANSPOSITION OF THE ULNAR NERVE

2016 ◽  
Vol 24 (4) ◽  
pp. 184-186
Author(s):  
Antonio Tufi Neder Filho ◽  
Regina de Azevedo Alves ◽  
Arlindo Gomes Pardini Júnior ◽  
Marcelo Riberto ◽  
Milton Mazer
Keyword(s):  
Ulnar Nerve ◽  
Ulnar Neuropathy ◽  
Anterior Transposition

Role of diffusion tensor imaging in the evaluation of ulnar nerve involvement in leprosy

2021 ◽  
pp. 20210290
Author(s):  
Ankita Aggarwal ◽  
Chandan Jyoti Das ◽  
Neena Khanna ◽  
Raju Sharma ◽  
Deep Narayan Srivastava ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Peripheral Neuropathy ◽  
Ulnar Nerve ◽  
Diffusion Tensor ◽  
Cross Sectional Area ◽  
Ulnar Neuropathy ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional

Objective: Early detection of peripheral neuropathy is extremely important as leprosy is one of the treatable causes of peripheral neuropathy. The study was undertaken to assess the role of diffusion tensor imaging (DTI) in ulnar neuropathy in leprosy patients. Methods: This was a case–control study including 38 patients (72 nerves) and 5 controls (10 nerves) done between January 2017 and June 2019. Skin biopsy proven cases of leprosy, having symptoms of ulnar neuropathy (proven on nerve conduction study) were included. MRI was performed on a 3 T MR system. Mean cross-sectional area, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of ulnar nerve at cubital tunnel were calculated. Additional ancillary findings and appearance of base sequences were evaluated. Results: Ulnar nerve showed thickening with altered T2W signal in all the affected nerves, having an average cross-sectional area of 0.26 cm2. Low FA with mean of 0.397 ± 0.19 and high ADC with mean of 1.28 ± 0.427 x 10 −3 mm2/s of ulnar nerve in retrocondylar groove was obtained. In the control group, mean cross-sectional area was 0.71cm2 with mean FA and ADC of 0.53 ± 0.088 and 1.03 ± 0.24 x 10 −3 mm2/s respectively. Statistically no significant difference was seen in diseased and control group. Cut-off to detect neuropathy for FA and ADC is 0.4835 and 1.1020 × 10 −3 mm2/s respectively. Conclusion: DTI though is challenging in peripheral nerves, however, is proving to be a powerful complementary tool for assessment of peripheral neuropathy. Our study validates its utility in infective neuropathies. Advances in knowledge: 1. DTI is a potential complementary tool for detection of peripheral neuropathies and can be incorporated in standard MR neurography protocol. 2. In leprosy-related ulnar neuropathy, altered signal intensity with thickening or abscess of the nerve is appreciated along with locoregional nodes and secondary denervation changes along with reduction of FA and rise in ADC value. 3. Best cut-offs obtained in our study for FA and ADC are 0.4835 and 1.1020 × 10 −3 mm2/s respectively.

Surgery of ulnar neuropathy at the elbow: 16 cases treated by decompression without transposition

1973 ◽  
Vol 38 (6) ◽  
pp. 780-785 ◽  
Author(s):  
Donald H. Wilson ◽  
Robert Krout
Keyword(s):  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Medial Epicondyle ◽  
Ulnar Neuropathy ◽  
Cubital Tunnel ◽  
Content Type ◽  
Anterior Transposition ◽  
Ulnar Nerve Palsy ◽  
Flexor Carpi Ulnaris ◽  
Fine Print

✓ The authors report 16 consecutive cases of ulnar nerve palsy at the elbow successfully relieved by simple division of the tendinous insertions of the flexor carpi ulnaris, which form the roof of the “cubital tunnel.” They believe the more complex procedures of anterior transposition of the nerve or resection of the medial epicondyle are unnecessary, and even undesirable.

scholarly journals Ulnar Neuropathy due to Intraneural Ganglion Cyst of the Ulnar Nerve at the Elbow

2018 ◽  
Vol 07 (03) ◽  
pp. 260-264 ◽  
Author(s):  
Byung-chul Son ◽  
Jin-gyu Choi ◽  
Hak-cheol Ko
Keyword(s):  
Ulnar Nerve ◽  
Elbow Joint ◽  
Glenohumeral Joint ◽  
Ganglion Cyst ◽  
Ulnar Neuropathy ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Articular Branch ◽  
Right Hand ◽  
Ganglion Cysts

AbstractIntraneural ganglion cysts are rare mucinous cyst originating within the epineurium of peripheral nerves. They occur most commonly in the peroneal nerve. However, they have also been described in many nerves in the vicinity of synovial joints. Intraneural ganglion cysts in the upper extremity are rare. Those at the elbow joint comprise only 9% of intraneural ganglion ever reported.A 66-year-old and right-handed male patient presented with a sudden onset of right-hand weakness. He initially noticed paresthesia with decreased sensation in the lateral two digits and radial palm in his right hand. Physical examination showed thenar muscle atrophy and muscle weakness of the abductor pollicis brevis in the right hand. Preoperative diagnosis of intraneural ganglion cyst was made on the basis of characteristic magnetic resonance imaging (MRI) findings. On exploration, the ulnar nerve was identified proximal to the elbow joint. Its articular branch was addressed and divided from the elbow joint.To the best of our knowledge, addressing the articular branch connecting the glenohumeral joint for the treatment of intraneural ganglion at the elbow has only been reported twice. We experienced a rare occurrence of intraneural ganglion cyst at the elbow manifesting an ulnar neuropathy. Here, we report intraoperative findings for the articular branch-connected to intraneural ganglion of the ulnar nerve at the elbow. Early diagnosis of intraneural ganglion with precise identification of the pathology and addressing the articular branch with atraumatic dissection of ganglion cyst are essential to achieve successful treatment for this rare lesion.

Peripheral Nerve Ultrasound and Short-Segment Nerve Conduction Studies Before and After Ulnar Nerve Decompression

2016 ◽  
Vol 35 (6) ◽  
pp. 1367-1368
Author(s):  
Jonathan K. Smith ◽  
Matthew E. Miller ◽  
David E. Reece ◽  
Yin-Ting Chen ◽  
Mark E. Landau
Keyword(s):  
Peripheral Nerve ◽  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Nerve Ultrasound ◽  
Short Segment ◽  
Nerve Decompression ◽  
Before And After

ABNORMAL ULNAR NERVE ANATOMY IN THE DISTAL FOREARM PRE-DISPOSES TO POST-TRAUMATIC ULNAR NEURITIS AT THE WRIST

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 303-305
Author(s):  
C. J. Yeo ◽  
C. P. Little ◽  
S. C. Deshmukh
Keyword(s):  
Ulnar Nerve ◽  
Anatomical Variations ◽  
Ulnar Neuropathy ◽  
Distal Forearm ◽  
Guyon’S Canal ◽  
Post Traumatic ◽  
Guyon's Canal ◽  
Ulnar Neuritis ◽  
Surgical Release

Anatomical variations of the ulnar nerve have been described at the level of the elbow and in Guyon's canal, while the path in the forearm has always been assumed to be constant. We present a case of compressive ulnar neuropathy at the wrist pre-disposed by a presumed congential variation of the path of the ulnar nerve at the level of the wrist which improved following surgical release of the constriction caused as a result of it.

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