Evidence‐based guideline: Neuromuscular ultrasound for the diagnosis of ulnar neuropathy at the elbow

Introduction/Aims The purpose of this literature review is to develop an evidence‐based guideline for the use of neuromuscular ultrasound in the diagnosis of ulnar neuropathy at the elbow (UNE). The proposed research question was: “In patients with suspected UNE, does ulnar nerve enlargement as meas...

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Published inMuscle & nerve Vol. 65; no. 2; pp. 147 - 153
Main Authors Shook, Steven J., Ginsberg, Matthew, Narayanaswami, Pushpa, Beekman, Roy, Dubin, Andrew H., Katirji, Bashar, Swaminathan, Bharathi, Werner, Robert A., Cartwright, Michael S.
Format Journal Article
LanguageEnglish
Published Hoboken, USA John Wiley & Sons, Inc 01.02.2022
Wiley Subscription Services, Inc
Subjects
Compression
Diagnosis
Diameters
Elbow
Elbow - diagnostic imaging
Elbow - innervation
Elbow Joint
electromyography
Humans
Literature reviews
Medical diagnosis
Meta-analysis
mononeuropathy
Neural Conduction - physiology
Neurology
Neuropathy
ulnar nerve
Ulnar Nerve - diagnostic imaging
Ulnar Neuropathies - diagnostic imaging
ulnar neuropathy at the elbow
Ultrasonic imaging
Ultrasonography
Ultrasound
ulnar nerve
mononeuropathy
ulnar neuropathy at the elbow
electromyography
ultrasound
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Summary:Introduction/Aims The purpose of this literature review is to develop an evidence‐based guideline for the use of neuromuscular ultrasound in the diagnosis of ulnar neuropathy at the elbow (UNE). The proposed research question was: “In patients with suspected UNE, does ulnar nerve enlargement as measured with ultrasound accurately identify those patients with UNE?” Methods A systematic review and meta‐analysis was performed, and studies were classified according to American Academy of Neurology criteria for rating articles for diagnostic accuracy. Results Based on Class I evidence in four studies, it is probable that neuromuscular ultrasound measurement of the ulnar nerve at the elbow, either of diameter or cross‐sectional area (CSA), is accurate for the diagnosis of UNE. Recommendation For patients with symptoms and signs suggestive of ulnar neuropathy, clinicians should offer ultrasonographic measurement of ulnar nerve cross‐sectional area or diameter to confirm the diagnosis and localize the site of compression (Level B).
Bibliography:The objectives of this activity are to: 1) Understand and be able to apply in clinical practice the Class I studies on ulnar neuropathy at the elbow; 2) Be able to use diameter and cross sectional area to assess ulnar neuropathy at the elbow; 3) Understand the role of ultrasound in the diagnosis of ulnar neuropathy at the elbow relative to clinical and electrodiagnostic evaluations.I have no conflicts of interest
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ISSN:0148-639X
1097-4598
DOI:10.1002/mus.27460