title: What causes ulnar neuropathy at the elbow?
abstract: OBJECTIVE
  To determine what causes ulnar neuropathy at the elbow (UNE) by analyzing patients' clinical, electrodiagnostic (EDx) and ultrasonographic (US) findings.
  
  
  METHODS
  In prospectively recruited patients with definite UNE, four blinded examiners took a history and performed neurologic, EDx and US examinations. A multivariate logistic regression model was used to investigate the association between UNE location and patient variables.
  
  
  RESULTS
  We included 117 patients; 73% with lesions in the retroepicondylar (RTC) groove and 27% under the humeroulnar aponeurotic arcade (HUA). In our multivariate model, hard manual labor (OR=152; 95% CI 12-1847; p<0.001), dominant arm involvement (OR=4.12; 95% CI 1.01-16.72; p=0.048), and age (OR=1.10; 95% CI 1.03-1.18; p=0.004) were predictive of ulnar neuropathy at HUA.
  
  
  CONCLUSIONS
  Our data suggest that UNE at HUA is related to years of hard labor affecting mainly dominant hands, and is caused by work-related changes in the HUA. By contrast, UNE in the RTC groove affects mainly the non-dominant arms of younger administrative workers and is caused by external compression of the ulnar nerve.
  
  
  CONCLUSIONS
  We believe that our findings will help to improve the diagnosis and treatment of UNE patients, hopefully leading to improved clinical outcomes.
authors.affiliation: Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Slovenia. Electronic address: gregor.omejec@kclj.si.
authors.forename: Gregor
authors.initials: G
authors.lastname: Omejec
authors.affiliation: Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Slovenia. Electronic address: simon.podnar@kclj.si.
authors.forename: Simon
authors.initials: S
authors.lastname: Podnar
mesh_terms: D000328:Adult; D000368:Aged; D004550:Elbow / Q000294:innervation* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011446:Prospective Studies; D020424:Ulnar Neuropathies / Q000175:diagnosis* / Q000209:etiology*
keywords: Electromyography; Nerve entrapment; Peripheral neuropathy; Ulnar nerve; Ultrasonography