Ann Rehabil Med.  2015 Apr;39(2):170-175. 10.5535/arm.2015.39.2.170.

Diagnostic Cutoff Value for Ultrasonography in the Ulnar Neuropathy at the Elbow

• Kim JH
• Won SJ
• Rhee WI
• Park HJ
• Hong HM

• KMID: 2273037
• DOI: http://doi.org/10.5535/arm.2015.39.2.170

Abstract

OBJECTIVE
To determine the diagnostic cutoff values of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE).
METHODS
Twenty-five elbows of 23 patients (9 females, 16 males) diagnosed with UNE and 30 elbows of 30 healthy controls (15 females, 15 males) were included in our study. The ulnar nerve cross-sectional area (CSA) was measured at the Guyon canal, midforearm, and maximal swelling point (MS) around the elbow (the cubital tunnel inlet in healthy controls). CSA measurements of the ulnar nerve at each point, the Guyon canal-to-MS ulnar nerve area ratio (MS/G), and the midforearm-to-MS ulnar nerve ratio (MS/F) were calculated.
RESULTS
Among the variables, only CSA at MS, MS/G, and MS/F displayed significant differences between the control and patient groups. The cutoff value for diagnosing UNE was 8.95 mm2 for the CSA at MS (sensitivity 93.8%, specificity 88.3%), 1.99 for the MS/G (sensitivity 75.0%, specificity 73.3%), and 1.48 for the MS/F (sensitivity 93.8%, specificity 95.0%).
CONCLUSION
These findings may be helpful to diagnose UNE.

Keyword

Ulnar neuropathies; Ultrasonography; Cross-sectional area; Cut-off value

MeSH Terms

Bays
Elbow*
Female
Humans
Ulnar Nerve
Ulnar Neuropathies*
Ultrasonography*
United Nations

Figure

• 

  Fig. 1 Cross-sectional views of the ulnar nerve ultrasonographic tracing in normal control. The ulnar nerve is shown within the dotted line. (A) Wrist at the Guyon canal level. Arrowheads show the flexor retinaculum. (B) Midforearm, where the nerve splits from the ulnar artery. (C) Cubital tunnel inlet at the medial epicondyle. The Osborne ligament is partially visualized (arrowheads). C, capitate bone; FCU, flexor carpi ulnaris; FDP, flexor digitorum profundus; FDS, flexor digitorum superficialis; ME, medial epicondyle; O, olecranon; P, pisiform bone; S, scaphoid bone; U, ulnar bone; UA, ulnar artery.

• 

  Fig. 2 A receiver operator characteristic (ROC) curve showing the relationship between the sensitivity and specificity for each ultrasonographic parameter in the diagnosis of ulnar neuropathy at the elbow. CSA, cross-sectional area; MS, maximal swelling point; MS/G, Guyon canal-to-MS ulnar nerve area ratio; MS/F, midforearm-to-MS ulnar nerve ratio.

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