title: The pathology of the ulnar nerve in acromegaly.
abstract: BACKGROUND
  Acromegalic patients may complain of sensory disturbances in their hands. Cubital tunnel syndrome, the ulnar nerve neuropathy at the cubital tunnel (UCT), in acromegalic patients has never been reported.
  
  
  OBJECTIVE
  To describe and assess the prevalence of UCT in acromegalic patients and the effects of 1 year of therapy on UCT.
  
  
  METHODS
  We examined prospectively 37 acromegalic patients with no history of polyneuropathy, acute trauma at the elbow, no diabetes or hypothyroidism with clinical examination, nerve conduction studies (NCS), and high-resolution ultrasound (US). A control group was made by 50 volunteers. The local ethics committee approved the study and written informed consent was obtained from all subjects involved in the study.
  
  
  METHODS
  Clinical history, physical examination, NCS, and US were used to diagnose UCT at the beginning of the study and after 1 year.
  
  
  RESULTS
  In 8 of 37 patients, a diagnosis of UCT was made at the beginning of the study reflecting a prevalence of 21%. After 1 year, 5 of 8 (62.5%) patients reported clinical and NCS improvements and evident US reduction of nerve cross-sectional area (CSA; 16.7+/-2.9 mm(2) vs 12.2+/-3.1 mm(2); P<0.001). In 3 of 8 (37.5%) patients, the UCT was unchanged. Ulnar nerve CSA was significantly increased in acromegalic patients with UCT (16.7+/-2.9 mm(2) vs 11.1+/-2.3 mm(2); P<0.047).
  
  
  CONCLUSIONS
  Ulnar neuropathy could occur in acromegalic patients and can improve in 62% of cases with disease control. Due to the different management and therapeutic approach, it would be important to make differential diagnosis between cubital and carpal tunnel syndrome in acromegaly.
authors.affiliation: Department of Radiology R, University of Genova, Viale Benedetto XV, 6, I-16132 Genova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
authors.forename: Eugenia
authors.initials: E
authors.lastname: Resmini
authors.forename: Raffaella
authors.initials: R
authors.lastname: Nizzo
authors.forename: Lorenzo E
authors.initials: LE
authors.lastname: Derchi
authors.forename: Francesco
authors.initials: F
authors.lastname: Minuto
authors.forename: Massimo
authors.initials: M
authors.lastname: Giusti
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
authors.forename: Diego
authors.initials: D
authors.lastname: Ferone
mesh_terms: D000172:Acromegaly / Q000453:epidemiology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D020430:Cubital Tunnel Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination; D015995:Prevalence; D011446:Prospective Studies; D014459:Ulnar Nerve / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography