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Diagnosing ulnar neuropathy at the elbow using magnetic resonance neurography

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Abstract

Introduction

Early diagnosis of ulnar neuropathy at the elbow is important. Magnetic resonance neurography (MRN) images peripheral nerves. We evaluated the usefulness of elbow MRN in diagnosing ulnar neuropathy at the elbow.

Methods

The MR neurograms of 21 patients with ulnar neuropathy were reviewed retrospectively. MRN was performed prospectively on 10 normal volunteers. The MR neurograms included axial T1 and axial T2 fat-saturated and/or axial STIR sequences. The sensitivity and specificity of MRN in detecting ulnar neuropathy were determined.

Results

The mean ulnar nerve size in the symptomatic and normal groups was 0.12 and 0.06 cm2 (P < 0.001). The mean relative signal intensity in the symptomatic and normal groups was 2.7 and 1.4 (P < 0.01). When using a size of 0.08 cm2, sensitivity was 95% and specificity was 80%.

Discussion

Ulnar nerve size and signal intensity were greater in patients with ulnar neuropathy. MRN is a useful test in evaluating ulnar neuropathy at the elbow.

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References

  1. Palmer BA, Hughes TB. Cubital tunnel syndrome. J Hand Surg. 2010;35A:153–63.

    Google Scholar 

  2. Shin R, Ring D. The ulnar nerve in elbow trauma. J Bone Joint Surg Am. 2007;89:1108–16.

    Article  PubMed  Google Scholar 

  3. Jillapalli D, Shefner JM. Electrodiagosis in common mononeuropathies and plexopathies. Semin Neurol. 2005;25:196–203.

    Article  PubMed  Google Scholar 

  4. Beekman R, Schreuder A, Rozeman C, Koehler P, Uitdehaag B. The diagnostic values of provocative clinical tests in ulnar neuropathy at the elbow is marginal. J Neurol Neurosurg Psychiatry. 2009;80:1369–74.

    Article  PubMed  CAS  Google Scholar 

  5. Kern RZ. The electrodiagnosis of ulnar nerve entrapment at the elbow. Can J Neurol Sci. 2003;30:314–9.

    PubMed  Google Scholar 

  6. Chhabra A, Lee PP, Bizzell C, Soldatos T. 3 Tesla MR neurography—technique, interpretation, and pitfalls. Skeletal Radiol. 2011. doi:10.1007/s00256-011-1183-6.

  7. Subhawong TK, Wang KC, Thawait SK, Williams EH, Hashemi SS, Machado AJ, et al. High resolution imaging of tunnels by magnetic resonance neurography. Skeletal Radiol. 2011 Apr 10.

  8. Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D. Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 2006;26:1267–87.

    Article  PubMed  Google Scholar 

  9. Li X, Shen J, Wang X, Liu Q, Liang B. Magnetic resonance imaging evaluation of acute crush injury of rabbit sciatic nerve: correlation with histology. Can Assoc Radiol J. 2008;59:123–30.

    PubMed  Google Scholar 

  10. Bendszus M, Wessig C, Solymosi L, Reiners K, Koltzenburg M. MRI of peripheral nerve degeneration and regeneration: correlation with electrophysiology and histology. Exp Neurol. 2004;188:171–7.

    Article  PubMed  Google Scholar 

  11. Vucic S, Cordato D, Yiannikas C, Schwartz R, Shnier R. Utility of magnetic resonance imaging in diagnosing ulnar neuropathy at the elbow. Clin Neurophysiol. 2006;117:590–6.

    Article  PubMed  CAS  Google Scholar 

  12. Britz G, Haynor D, Kuntz C, Goodkin R, Gitter A, Maravilla K, et al. Ulnar nerve entrapment at the elbow: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings. Neurosurgery. 1996;38(3):458–65.

    PubMed  CAS  Google Scholar 

  13. Baumer P, Dombert T, Staub F, Kaestel T, Bartsch AJ, Heiland S, et al. Ulnar neuropathy at the elbow: MR neurography—nerve T2 signal increase and caliber. Radiology. 2011;260(1):199–206.

    Article  PubMed  Google Scholar 

  14. Smith AB, Gupta N, Strober J, Chin C. Magnetic resonance neurography in children with birth-related brachial plexus injury. Pediatr Radiol. 2008;38:159–63.

    Article  PubMed  Google Scholar 

  15. Grant GA, Britz GW, Goodkin R, Jeffrey GJ, Maravilla K, Kliot M. The utility of magnetic resonance imaging in evaluating peripheral nerve disorders. Muscle Nerve. 2002;25:314–31.

    Article  PubMed  Google Scholar 

  16. Kuntz C, Blake L, Britz G, Filler AG, Hayes C, Goodkin R, et al. Magnetic resonance neurography of peripheral nerve lesions in the lower extremity. Neurosurgery. 1996;39:750–7.

    Article  PubMed  Google Scholar 

  17. Sammer DM, Chung KC. Tendon transfers: part I. Principles of transfer and transfers for radial nerve palsy. Plast Reconstr Surg. 2009;123:169e–77.

    Article  PubMed  CAS  Google Scholar 

  18. Sammer DM, Chung KC. Tendon transfers part II: transfers for ulnar nerve palsy and median nerve palsy. Plast Reconstr Surg. 2009;124:212e–21.

    Article  PubMed  Google Scholar 

  19. Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology. 2009;252:148–56.

    Article  PubMed  Google Scholar 

  20. Costa DN, Pedrosa I, McKenzie C, Reeder SB, Rofsky NM. Body MRI using IDEAL. AJR Am J Roentgenol. 2008;190(4):1076–84.

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Lynne S. Steinbach.

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Keen, N.N., Chin, C.T., Engstrom, J.W. et al. Diagnosing ulnar neuropathy at the elbow using magnetic resonance neurography. Skeletal Radiol 41, 401–407 (2012). https://doi.org/10.1007/s00256-011-1251-y

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  • DOI: https://doi.org/10.1007/s00256-011-1251-y

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