Evaluation of the ulnar nerve with shear-wave elastography: a potential sonographic method for the diagnosis of ulnar neuropathyopen access
- Authors
- Kim, Sujin; Lee, Guen Young
- Issue Date
- Jul-2021
- Publisher
- KOREAN SOC ULTRASOUND MEDICINE
- Keywords
- Ulnar neuropathy; Cubital tunnel syndrome; Medial epicondyle pain; Shear-wave elastography
- Citation
- ULTRASONOGRAPHY, v.40, no.3, pp 349 - 356
- Pages
- 8
- Journal Title
- ULTRASONOGRAPHY
- Volume
- 40
- Number
- 3
- Start Page
- 349
- End Page
- 356
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/49861
- DOI
- 10.14366/usg.20101
- ISSN
- 2288-5919
2288-5943
- Abstract
- Purpose: This study was designed to verify whether shear-wave elastography (SWE) can be used to differentiate ulnar neuropathy at the cubital tunnel from asymptomatic ulnar nerve or medial epicondylitis. An additional aim was to determine a cut-off value to identify patients with ulnar neuropathy. Methods: This study included 10 patients with ulnar neuropathy at the cubital tunnel as confirmed with electromyography (three women and seven men; mean age, 51.9 years), 10 patients with medial epicondylitis (nine women and one man; mean age, 56.1 years), and 37 patients with asymptomatic ulnar nerve and lateral epicondylitis (21 women and 16 men; mean age, 54.0 years). Each patient underwent SWE of the ulnar nerve at the cubital tunnel, distal upper arm, and proximal forearm. Results: Patients with ulnar neuropathy at the cubital tunnel exhibited significantly greater mean ulnar nerve stiffness at the cubital tunnel (66.8 kPa) than controls with medial epicondylitis (21.2 kPa, P=0.015) or lateral epicondylitis (33.9 kPa, P=0.040). No significant differences were observed between patients and controls with regard to ulnar nerve stiffness at the distal upper arm or the proximal forearm. A stiffness of 31.0 kPa provided 100% specificity, 80.0% sensitivity, 100% positive predictive value, and 83.3% negative predictive value for the differentiation between ulnar neuropathy and medial epicondylitis. Conclusion: Cubital tunnel syndrome is associated with a stiffer ulnar nerve than lateral or medial epicondylitis. SWE seems to be a new, reliable, and simple quantitative diagnostic technique to aid in the precise diagnosis of ulnar neuropathy at the cubital tunnel.
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