Ultrasonography in patients with ulnar neuropathy at the elbow: comparison of cross-sectional area and swelling ratio with electrophysiological severity.
The aim of this study was to determine the diagnostic value of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE) and to assess the relationship between the measurements and the electrophysiological severity. The largest anteroposterior diameter (LAPD) and cross-sectional area (CSA) measurements of the ulnar nerve were noted at multiple levels along the arm, and the distal-to-proximal ratios were calculated. Almost all of the measurements and swelling ratios between patients and controls showed statistically significant differences. The largest CSA, distal/largest CSA ratio, CSA at the epicondyle, and proximal LAPD had larger areas under the curve than other measurements. The sensitivity and specificity in diagnosing UNE were 95% and 71% for the largest CSA, 83% and 85% for the distal/largest CSA ratio, 83% and 81% for the CSA at the epicondyle, and 93% and 43% for the proximal LAPD, respectively. There was a statistically significant correlation between the electrophysiological severity scale score (ESSS) and the largest CSA, the CSA at the epicondyle and 2 cm proximal to the epicondyle, and the LAPD at the level of the epicondyle (P < 0.05). None of the swelling ratios showed a significant correlation with the ESSS. The largest CSA measurement is the most valuable ultrasonographic measurement both for diagnosis and determining the severity of UNE.
Bayrak
Ayse Oytun
AO
Department of Neurology, Ondokuz Mayis University School of Medicine, 55139 Samsun, Turkey. oytun.bayrak@gmail.com
Bayrak
Ilkay Koray
IK
Turker
Hande
H
Elmali
Muzaffer
M
Nural
Mehmet Selim
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D020430:Cubital Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D003661:Decision Support Techniques; D004185:Disability Evaluation; D004487:Edema / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D004568:Electrodiagnosis; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D011237:Predictive Value of Tests; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014459:Ulnar Nerve / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D014463:Ultrasonography; D055815:Young Adult