Skip to main content
SpringerLink
Log in

Ultrasound of the Ulnar Nerve at the Elbow

  • Chapter
  • First Online:
Ultrasonography for the Upper Limb Surgeon

  • 637 Accesses

Abstract

The lesions of the ulnar nerve at the elbow are the most common nerve damage to the upper limb after that of the carpal tunnel [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jacobson JA, Fessell DP, Lobo Lda G, Yang LJ. Entrapment neuropathies I: upper limb (carpal tunnel excluded). Semin Musculoskelet Radiol. 2010;14(5):473–86. https://doi.org/10.1055/s-0030-1268068. Epub 2010 Nov 11.

    Article  PubMed  Google Scholar 

  2. Bianchi S, Martinoli C. Elbow. In: Ultrasound of the musculoskeletal system. Springer; 2007. p. 349–407.

    Chapter  Google Scholar 

  3. Jacob D, Lambert A. Ultrasound of the posterior side of the elbow. In: Brewer JL, Fustier A, Mercy G, Monzani Q, Lucidarme O, editors. News in ultrasound of the locomotor appareil, vol. 14. Montpellier: Medical Sauramps; 2017. p. 281–98.

    Google Scholar 

  4. Coraci D, Giovannini S, Loreti C, Di Sante L, Santilli V, Padua L. Ultrasonographic appearance of ulnar nerve at different points of elbow. Eur J Radiol. 2018;102:228–30. https://doi.org/10.1016/j.ejrad.2017.12.023. Epub 2017 Dec 28.

    Article  PubMed  Google Scholar 

  5. Okamoto M, Abe M, Shirai H, Ueda N. Diagnosis ultrasonography of the ulnar nerve in cubital tunnel syndrome. J Hand Surg Br. 2000;25(5):499–502.

    Article  CAS  PubMed  Google Scholar 

  6. Beekman R, Visser LH, Verhagen WI. Ultrasonography in ulnar neuropathy at the elbow: a critical review. Nerve Muscle. 2011;43(5):627–35. https://doi.org/10.1002/mus.22019.

    Article  Google Scholar 

  7. Schertz M, Mutschler C, Masmejean E, Silvera J. High-resolution ultrasound in etiological evaluation of ulnar neuropathy at the elbow. Eur J Radiol. 2017;95:111–7. https://doi.org/10.1016/j.ejrad.2017.08.003. Epub 2017 Aug 7.

    Article  PubMed  Google Scholar 

  8. Shen PC, Chern TC, Wu KC, Tai TW, Jou IM. The assessment of the ulnar nerve at the elbow by ultrasonography in children. J Bone Joint Surg Br. 2008;90(5):657–61. https://doi.org/10.1302/0301-620X.90B5.19820.

    Article  PubMed  Google Scholar 

  9. Yoon JS, Hong SJ, Kim BJ, Kim SJ, Kim JM, Walker FO, Cartwright MS. Ulnar nerve and cubital tunnel ultrasound in ulnar neuropathy at the elbow. Arch Phys Med Rehabil. 2008;89(5):887–9. https://doi.org/10.1016/d.apmr.2007.10.024.

    Article  PubMed  Google Scholar 

  10. Volpe A, Rossato G, Bottanelli M, Marchetta A, Caramaschi P, Bambara LM, et al. Ultrasound evaluation of ulnar neuropathy at the elbow: correlation with electrophysiological studies. Rheumatology (Oxford). 2009;48(9):1098–101. https://doi.org/10.1093/rheumatology/kep167. Epub 2009 Jun 30.

    Article  Google Scholar 

  11. Jacob D, Lambert A, Cohen M. The ulnar nerve at the elbow and elsewhere. In: The peripheral nerve. Montpellier: Sauramps; 2015. p. 237–55.

    Google Scholar 

  12. Jacob D, Lambert A, Cohen M. Ultrasound of struthers arcade. In: Brasseur JL, Mercy G, Monzani Q, Benayan E, Grenier P, editors. News in ultrasound of the musculoskeletal system, vol. 12. Montpellier: Medical Sauramps; 2015. p. 103–12.

    Google Scholar 

  13. Tubbs RS, Deep A, Shoja MM, Mortazavi MM, Loukas M, Cohen-Gadol AA. The arcade of Struthers: an anatomical study with potential neurosurgical significance. Surg Neurol Int. 2011;2:184.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Camerlinck M, Vanhoenacker FM, Kiekens G. Ultrasound demonstration of Struthers’ ligament. J Wink Ultrasound. 2010;38(9):499–502.

    Article  Google Scholar 

  15. Gelberman HR, Yamaguchi K, Hollstien SB, Winn SS, Heidenreich FP Jr, Bindra RR, et al. Changes in interstitial pressure and cross-sectional area of the cubital tunnel and of the ulnar nerve with flexion of the elbow. An experimental study in human cadavera. J Bone Joint Surg Am. 1998;80(4):492–501.

    Article  CAS  PubMed  Google Scholar 

  16. Michelin P, Leleup G, Duparc F. Ligamentous biomechanics of the cubital tunnel. In: Brewer JL, Fustier A, Mercy G, Monzani Q, Lucidarme O, editors. News in ultrasound of the musculoskeletal system, vol. 14. Montpellier: Medical Sauramps; 2017. p. 339–52.

    Google Scholar 

  17. Michelin P, Leleup G, Ould-Slimane M, Merlet MC, Dubourg P, Duparc F. Ultrasound biomechanical anatomy of the soft structures in relation to the ulnar nerve in the cubital tunnel of the elbow. Surg Radiol Anat. 2017;39(11):1215–21.

    Article  PubMed  Google Scholar 

  18. James J, Sutton LG, Werner FW, Basu N, Allison MA, Palmer AK. Morphology of the cubital tunnel: an anatomical and biomechanical study with implications for treatment of ulnar nerve compression. J Hand Surg Am. 2011;36(12):1988–95. https://doi.org/10.1016/jhsa.2011.09.014. Epub 2011 Nov 3.

    Article  PubMed  Google Scholar 

  19. Yang SN, Yoon JS, Kim SJ, Kang HJ, Kim SH. Movement of the ulnar nerve at the elbow: a sonographic study. J Ultrasound Med. 2013;32(10):1747–52. https://doi.org/10.7863/ultra.32.10.1747.

    Article  PubMed  Google Scholar 

  20. Okamoto M, Abe M, Shirai H, Ueda N. Morphology and dynamics of the ulnar nerve in the cubital tunnel. Observation by ultrasonography. J Hand Surg Br. 2000;25(1):85–9.

    Article  CAS  PubMed  Google Scholar 

  21. Jacob D, Creteur V, Courthaliac C, Bargoin R, Sassus B, Bacq C, Rozies JL, Casket JP, Brewer JL. Sonoanatomy of the ulnar nerve in the cubital tunnel: a multicentre study by the GEL. Eur Radiol. 2004;14(10):1770–3. Epub 2004 Jul 17.

    Article  CAS  PubMed  Google Scholar 

  22. Yoon JS, Walker FO, Cartwright MS. Ultrasonographic swelling ratio in the diagnosis of ulnar neuropathy at the elbow. Nerve Muscle. 2008;38(4):1231–5. https://doi.org/10.1002/mus.21094.

    Article  Google Scholar 

  23. Pompe SM, Beekman R. Which ultrasonographic measure has the upper hand in ulnar neuropathy at the elbow? Clin Neurophysiol. 2013;124(1):190–6. https://doi.org/10.1016/j.clinph.2012.05.030. Epub 2012 Oct 1.

    Article  PubMed  Google Scholar 

  24. Chang KV, Wu WT, Han DS, Ozçakar L. Ulnar nerve cross-sectional area for the diagnosis of cubital tunnel syndrome: a meta-analysis of ultrasonographic measurements. Arch Phys Med Rehabil. 2018;99(4):743757. https://doi.org/10.1016/j.apmr.2017.08.467. Epub 2017 Sep 6.

    Article  Google Scholar 

  25. Assmus H, Antoniadis G, Bischoff C, Hoffmann R, Martini AK, Preissler P, Scheglmann K, Schwerdtfeger K, Wessels KD, Wüstner-Hofmann M. Cubital tunnel syndrome a review and management guidelines. Cent Eur Neurosurg. 2011;72(2):90–8. https://doi.org/10.1055/s-0031-1271800. Epub 2011 May 4.

    Article  CAS  PubMed  Google Scholar 

  26. Bayrak AO, Bayrak IK, Turker H, Elmali M, Nural MS. Ultrasonography in patients with ulnar neuropathy at the elbow: comparison of cross-sectional area and swelling ratio with electrophysiological severity. Nerve Muscle. 2010;41(5):661–6. https://doi.org/10.1002/mus.21563.

    Article  Google Scholar 

  27. Terayama Y, Uchiyama S, Ueda K, Iwakura N, Ikegami S, Kato Y, Kato H. Optimal measurement level and ulnar nerve cross-sectional area cutoff threshold for identifying ulnar neuropathy at the elbow by MRI and ultrasonography. J Hand Surg Am. 2018;43(6):529–36. https://doi.org/10.1016/j.jhsa.2018.02.022. Epub 2018 Apr 3.

    Article  PubMed  Google Scholar 

  28. Paluch Ł, Noszczyk B, Nitek Z, Walecki J, Osiak K, Pietruski P. Shear-wave elastography: a new potential method to diagnose ulnar neuropathy at the elbow. Eur Radiol. 2018;28(12):4932–9. https://doi.org/10.1007/s00330-018-5517-9. Epub 2018 Jun 1.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Paluch Ł, Noszczyk BH, Walecki J, Osiak K, Kiciński M, Pietruski P. Shear-wave elastography in the diagnosis of ulnar tunnel syndrome. J Plast Reconstr Aesthet Surg. 2018;71(11):1593–9. https://doi.org/10.1016/d.bjps.2018.08.018. Epub 2018 Sep 4.

    Article  CAS  PubMed  Google Scholar 

  30. Bjerre JJ, Johannsen FE, Rathcke M, Krogsgaard MR. Snapping elbow-a guide to diagnosis and treatment. World J Orthop. 2018;9(4):65–71. https://doi.org/10.5312/wjo.v9.i4.65. eCollection 2018 Apr 18.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Steinert AF, Goebel S, Rucker A, Barthel T. Snapping elbow caused by hypertrophic synovial plica in the radiohumeral joint: a report of three cases and review of literature. Arch Orthop Trauma Surg. 2010;130(3):347–51. https://doi.org/10.1007/s00402-008-0798-0. Epub 2008 Dec 17.

    Article  PubMed  Google Scholar 

  32. Spinner RJ, Goldner RD. Snapping of the medial head of the triceps and recurrent dislocation of the ulnar nerve. Anatomical and dynamic factors. J Bone Joint Surg Am. 1998;80(2):239–47.

    Article  CAS  PubMed  Google Scholar 

  33. Bozkurt MC, Tağil SM, Ozçakar L, Ersoy M, Tekdemir I. Anatomical variations as potential risk factors for ulnar tunnel syndrome: a cadaveric study. Clin Anat. 2005;18(4):274–80.

    Article  PubMed  Google Scholar 

  34. Uscetin I, Bingol D, Ozkaya O, Orman C, Akan M. Ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle: a case report and surgical approach. Turk Neurosurg. 2014;24(2):266–71. https://doi.org/10.5137/1019-5149.JTN.6913-12.0.

    Article  PubMed  Google Scholar 

  35. Erdem Bagatur A, Yalcin MB, Ozer EU. Anconeus epitrochlearis muscle causing ulnar neuropathy at the elbow: clinical and neurophysiological differential diagnosis. Orthopedics. 2016;39(1):988–91.

    Google Scholar 

  36. Li P, Lou D, Lu H. The cubital tunnel syndrome caused by intraneural ganglion cyst of the ulnar nerve at the elbow: a case report. BMC Neurol. 2018;18(1):217. https://doi.org/10.1186/s12883-018-1229-7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chang WK, Li YP, Zhang DF, Liang BS. The cubital tunnel syndrome caused by the intraneural or extraneural ganglion cysts: case report and review of the literature. J Plast Reconstr Aesthet Surg. 2017;70(10):14041408. https://doi.org/10.1016/j.bjps.2017.05.006. Epub 2017 Jul 6.

    Article  Google Scholar 

  38. Bathala L, Krishnam VN, Kumar HK, Neladimmanahally V, Nagaraju U, Kumar HM, Telleman JA, Visser LH. Extensive sonographic ulnar nerve enlargement above the medial epicondyle is a characteristic sign in Hansen’s neuropathy. PLoS Negl Trop Dis. 2017;11(7):e0005766. https://doi.org/10.1371/journal.pntd.0005766. eCollection 2017 Jul.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Gallon A, Pérignon R, Lhoste-Trouilloud A. Imaging the nerve damage of leprosy. In: Brasseur JL, Mercy G, Monzani Q, Benayan E, Grenier P, editors. News in ultrasound of the musculoskeletal system, vol. 12. Montpellier: Medical Sauramps; 2015. p. 143–58.

    Google Scholar 

  40. Lucchina S, Fusetti C, Guidi M. Sonographic follow-up of patients with cubital tunnel syndrome undergoing in situ open neurolysis or endoscopic release: the SPECTRE study. Hand (N Y). 2021;16(3):385–90. https://doi.org/10.1177/1558944719857816. [Epub ahead of print].

    Article  Google Scholar 

  41. Simon NG, Ralph JW, Poncelet AN, Engstrom JW, Chin C, Kliot M. A comparison of ultrasonographic and electrophysiologic ‘inching’ in ulnar neuropathy at the elbow. Clin Neurophysiol. 2015;126(2):391–8. https://doi.org/10.1016/j.clinph.2014.05.023. Epub 2014 Jun 4.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, G.H. Pitié-Salpêtrière, Paris, France

    Jean Louis Brasseur

Authors
  1. Jean Louis Brasseur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean Louis Brasseur .

Editor information

Editors and Affiliations

  1. Centre d’échochirurgie de la main, Hôpital Privé de Versailles, Versailles, France

    Thomas Apard

  2. Radio-diagnostic, Pitié-Salpêtrière Hospital, Paris, France

    Jean Louis Brasseur

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Brasseur, J.L. (2022). Ultrasound of the Ulnar Nerve at the Elbow. In: Apard, T., Brasseur, J.L. (eds) Ultrasonography for the Upper Limb Surgeon. Springer, Cham. https://doi.org/10.1007/978-3-030-84234-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84234-5_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84233-8

  • Online ISBN: 978-3-030-84234-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation