Cubital tunnel syndrome

Cumulative trauma disorders (CTDs), also referred to as repetitive-motion injuries, result from excessive use of the hand, wrist, or forearm. As with overexertion injuries, the frequency and costs of CTDs are growing to epidemic proportions. Some of the most common cumulative trauma disorders are carpal tunnel syndrome, cubital tunnel syndrome, tendinitis, and tenosynovitis. 

Cubital Tunnel Syndrome is compression of the ulnar nerve in the elbow, thought to be caused by resting the elbow on a hard surface or sharp edge. Symptoms include tingling in the ring finger and little finger. 

Chiou HJ, Chou YH, Cheng SP et al (1998) Cubital tunnel syndrome diagnosis by high-resolution ultrasonography. J Ultrasound Med 17 643-648... 

Nakamichi K, Tachibana S, Kitajima I (2000) Ultrasonography in the diagnosis of ulnar tunnel syndrome caused by an occult ganglion. J Hand Surg [Br] 25 503-504 Okamoto M, Abe M, Shirai H et al (2000) Diagnostic ultrasonography of the ulnar nerve in cubital tunnel syndrome. J Hand Surg [Br] 5 499-502... 

Essentials of Clinical History and Physical Examination 358 Tendon Abnormalities 358 Ligament Instability 358 Cubital Tunnel Syndrome 358... 

A useful clinical maneuver to assess the state of the ulnar nerve is the Froment s test . The patient is asked to pinch a sheet of paper between thumb and index finger. In case of overt ulnar neuropathy, the patient grasps the paper by flexing the thumb (activation of the median-innervated flexor pollicis longus as a compensation for the weakness of dorsal interosseous muscles) (see Sect. 8.5.4.3). In patients with cubital tunnel syndrome, palpation of the ulnar nerve at the cubital tunnel may be painful and may reproduce symptoms. 

Fig. 8.57a-d. Cubital tunnel syndrome in a patient with anconeus epitrochlearis muscle, a Short-axis and b long-axis 12-5 MHz US images of the cubital tunnel reveal the anconeus epitrochlearis muscle (straight arrows) that lies between the medial epicondyle (ME) and the olecranon (0) in close relation with a swollen ulnar nerve (curved arrow). Correlative transverse c Tlw SE and d fat-suppressed T2w SE MR images demonstrate the aberrant muscle (straight arrows) within the cubital tunnel. In d, the ulnar nerve (curved arrow) appears markedly hyperintense as a result of compression neuropathy. ME, medial epicondyle 0, olecranon... 

Okamoto M, Abe M, Shirai H et al (2000) Diagnostic ultrasonography of the ulnar nerve in cubital tunnel syndrome. J Hand Surg [Br] 25 499-502... 

Compared with carpal tunnel and cubital tunnel syndrome, ulnar neuropathy at the Guyon canal is rare. 

Dynamic US of the elbow can be used to help demonstrate abnormal dislocation of the ulnar nerve, with or without snapping triceps syndrome. This finding typically occurs in the cubital tunnel, an osteofibrous tunnel formed by a groove between the olecranon and the medial epicondyle and bridged by the Osborn retinaculum. As described in Chapter 8, dynamic scanning during full elbow flexion can allow continual depiction of the intermittent dislo-... 

Fig. 8.64a,b. Snapping triceps syndrome. Schematic drawings of the posterior aspect of the elbow in a extension and b 90° flexion demonstrate the ulnar nerve (arrows) as it passes through the cubital tunnel and a prominent medial head (mh) of the triceps muscle (tin). Note the absence of the Osborne retinaculum when compared with Fig. 8.7c. With elbow flexion, the medial edge of the triceps (arrowheads) and the ulnar nerve move anterior to the tip of the epicondyle. T, distal triceps tendon /c , flexor carpi ulnaris...

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