Abstract
Objective
To assess the correlation between ultrasonographic and electrodiagnostic findings
to determine the localization of the ulnar trapping at the elbow.
Design
Cross-sectional and noninterventional trial.
Setting
Physical medicine and rehabilitation department of a teaching hospital.
Participants
Patients (N=14) diagnosed with ulnar nerve entrapment using short-segment nerve conduction
study.
Interventions
The elbow area was divided into 4 segments with 2-cm intervals. All patients underwent
ultrasonographic and electrodiagnostic examinations.
Main Outcome Measures
The nerve conduction velocity (NCV) of each segment was measured. The cross-sectional
area (CSA) of the ulnar nerve was measured at 5 levels. The proximal CSA/distal CSA
ratio (PDR) was calculated by proportioning the CSA values for each segment. The highest
PDR was accepted as a trapping segment, whereas the segment with the lowest NCV was
accepted electrophysiologically (provided it was <50m/s).
Results
A total of 80 PDR and NCV measurements were taken from 20 elbows. A statistically
significant negative correlation (r=−.554; P<.001) was found between general PDR and NCV values. When we assumed that the NCV
value <50m/s as the criterion standard for diagnosis, the cutoff value for the PDR
was found to be 1.08, with a sensitivity of 70% and a specificity of 92.5%. The minimum
NCV value and the maximum PDR value were mostly seen in the third segment compatible
with the cubital tunnel.
Conclusions
Ultrasonography seems to be advantageous because it is more comfortable for the patient
and requires shorter time than does electroneuromyography. To our knowledge, this
is the first study to detect ulnar nerve entrapment by using not only CSA but also
PDR as a ratio method with ultrasound.
Keywords
List of abbreviations:
CSA (cross-sectional area), ENMG (electroneuromyography), ICC (intraclass correlation coefficient), NCV (nerve conduction velocity), PDR (proximal cross-sectional area/distal cross-sectional area ratio), UNE (ulnar nerve entrapment), US (ultrasound)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 05, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
