Ultrasound Assessment of the Ulnar Nerve Around the Elbow and Diagnosis of Cubital Tunnel Syndrome, Clinical Outcomes.

IF 1.8 Q2 ORTHOPEDICS

HAND Pub Date : 2025-01-01 Epub Date: 2023-08-03 DOI:10.1177/15589447231187081

Michael Catanzaro, Gabrielle Santangelo, David Speach, Constantinos Ketonis

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引用次数: 0

Abstract

Background: There is increased interest in ultrasound (US) for the diagnosis of cubital tunnel syndrome (CuTS). We hypothesize that ulnar nerve cross-sectional area (CSA) correlates with disease severity and electrodiagnostic studies (EDX).

Methods: ARetrospective review was performed at a tertiary medical center. One hundred seventeen patients (166 ulnar nerves) were evaluated. Maximum CSA at 3 points around the elbow (proximal, groove, and distal) and EDX results (American Board of Electrodiagnostic Medicine-certified physiatrist's interpretations) were collected.

Results: US was positive (CSA > 0.1 cm²) in 95/117 cases (81.20%) versus 84/117 (71.79%) positive for EDX. CuTS patients treated surgically had significantly greater (0.13 cm², standard deviation [SD] 0.038) preoperative CSA than non-operative patients (0.10 cm², SD 0.033) (p = .003). CSA increased as EDX increased in severity; mild (0.116 cm², SD 0.031), moderate (0.121 cm², SD 0.035), and severe (0.163 cm², SD 0.047) with a significant difference between the mild and severe groups (P = .001) and between the moderate and severe groups (p = .01). Significant differences were seen between patients with positive US and EDX studies compared to those with negative US and EDX in the average physical function scores (57.26, SD 8.57 versus 43.18, SD 7.70; p < .001); average sleep scores (50.14, SD 9.53 versus 56.62, SD 7.31; p = .02); average physical function scores (43.04, SD 8.68 versus 57.08, SD 6.34; p < .001) and average depression scores (49.10, SD 10.88 versus 45.043, SD 7.06; p = .02).

Conclusions: US is a reliable tool for diagnosis and surgical decision-making for CuTS.

Type of study/level of evidence: Diagnostic/III.

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肘周尺神经的超声检查与肘管综合征的诊断，临床结果。

背景：超声（US）对肘管综合征（CuTS）的诊断越来越感兴趣。我们假设尺神经横截面积（CSA）与疾病严重程度和电诊断研究（EDX）相关。方法：对某三级医疗中心进行回顾性研究。117例患者（166条尺神经）进行了评估。收集肘部周围3个点（近端、沟端和远端）的最大CSA和EDX结果（美国电诊断医学委员会认证的物理医生的解释）。结果：95/117例（81.20%）US阳性（CSA bb0 0.1 cm2）， 84/117例（71.79%）EDX阳性。手术患者术前CSA （0.13 cm2，标准差[SD] 0.038）显著高于非手术患者（0.10 cm2, SD 0.033）（p = 0.003）。CSA随着EDX严重程度的增加而增加；轻度（0.116 cm2, SD 0.031）、中度（0.121 cm2, SD 0.035）、重度（0.163 cm2, SD 0.047），轻度组与重度组、中度组与重度组间差异均有统计学意义（P = 0.001）。与US和EDX阴性患者相比，US和EDX阳性患者在平均身体功能评分方面存在显著差异(57.26,SD 8.57 vs 43.18, SD 7.70；P < 0.001)；平均睡眠评分(50.14,SD 9.53 vs . 56.62, SD 7.31；P = .02)；平均身体功能评分（43.04,SD 8.68 vs 57.08, SD 6.34）；p < 0.001)和平均抑郁评分(49.10,SD 10.88 vs 45.043, SD 7.06；P = .02)。结论：超声是诊断和手术决策的可靠工具。研究类型/证据水平：诊断性/III。

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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.