Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome?

Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome?

Aim: The aim of the study was to determine the diagnostic value of clinical history and neurological examination for cubital tunnelsyndrome.Materials and Methods: 132 limbs of 128 patients treated with electromyography with a preliminary clinical diagnosis of cubitaltunnel syndrome between the years of January 2009 and January 2016 were evaluated. Patients were evaluated according togender, affected side and electromyography results to assess the presence of neuropathy. The obtained data were statisticallyanalyzed by Kormogonov-Smirnov and Shapiro-Wilk test.Results: 70 patients (54%) were male and 58 (46%) were female and the average age was 40.25±12.66. The affected side was rightextremity in 70 (53%) of cases and left extremity in 62 (47%) who underwent electromyography with a preliminary diagnosis ofneuropathy. Symptoms were bilateral in 4 cases. As a result of electromyography 43 (32.6%) (27 male, 16 female) patients hadneuropathy. Affected side in 23 of these patients (53.5%) was left limb and 20 (46.5%) was right limb and 30 of involved patientswere in the range of 30-60 years.Conclusion: According to the results of our study, we found that history and neurological examination have a low efficiency in thediagnosis of cubital tunnel syndrome. This may be associated with relatively subjective evaluation of neurological examination andhistory and also many pathologies in the differential diagnosis of cubital tunnel syndrome. We believe that electromyelographyapplication is required in addition to a detailed physical examination for cubital tunnel syndrome in order to avoid delayeddiagnosis and incomplete/incorrect treatment.

___

  • Novak CB, Lee GW, Mackinnon SE, Lay L. Provocative testing for cubital tunnel syndrome. J Hand Surg Am 1994;19(5):817–20.
  • Palmer BA, Hughes TB. Cubital tunnel syndrome. J Hand Surg Am 2010;35(1):153–63.
  • McGOWAN AJ. The results of transposition of the ulnar nerve for traumatic ulnar neuritis. J Bone Joint Surg Br 1950;32-B(3):293-301.
  • Macadam SA, Bezuhly M, Lefaivre KA. Outcomes measures used to assess results after surgery for cubital tunnel syndrome: a systematic review of the literature. J Hand Surg Am 2009;34(8):1482-91e5.
  • Trehan SK, Parziale JR, Akelman E. Cubital tunnel syndrome: diagnosis and management. Med Health R I 2012;95(11):349-52.
  • Harder K, Diehm J, Fassola I, Al Khaled N, Doll D, Dunda SE. et al. Current diagnostics and treatment of the cubital tunnel syndrome in Austria. GMS Interdiscip Plast Reconstr Surg DGPW 2016;18;5:Doc03.
  • Martinoli C, Bianchi S, Pugliese F, Bacigalupo L, Gauglio C, Valle M. et al. Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound 2004;32(9):438-50.
  • 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.
  • Martinoli C. Imaging of the peripheral nerves. Semin Musculoskelet Radiol 2010;14(5):461-2.
  • Bozentka DJ. Cubital tunnel syndrome pathophysiology. Clin Orthop Relat Res 1998;351(351):90-4.
  • Eroğlu M, Er MS, Altınel L, Eroğlu S. Assessment of frequency and severity of clinical findings related to carpal tunnel syndrome in patients undergoing hemodialysis therapy. Abant Med J 2014;3(3):210-4.
  • Soltani AM, Best MJ, Francis CS, Allan BJ, Panthaki ZJ. Trends in the surgical treatment of cubital tunnel syndrome: an analysis of the national survey of ambulatory surgery database. J Hand Surg Am. 2013;38(8):1551-6.
  • Chemali KR, Tsao B. Electrodiagnostic testing of nerves and muscles: when, why, and how to order. Cleve Clin J Med 2005;72(1):37-48.
  • Assmus H, Antoniadis G, Bischoff C. Carpal and cubital tunnel and other, rarer nerve compression syndromes. Dtsch Arztebl Int 2015;112(1-2):14-25.
  • Mondelli M, Giannini F, Ballerini M, Ginanneschi F, Martorelli E. Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy). J Neurol Sci 2005;15;234:(1-2)5-10.
İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi-Cover
  • ISSN: 1300-1744
  • Yayın Aralığı: Yılda 4 Sayı
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi