Letissier Hoel, Dardenne Guillaume, Saraux Alain, Le Nen Dominique, Borotikar Bhushan, Jousse-Joulin Sandrine
Service de Chirurgie Orthopédique et Traumatologique, Hôpital de la Cavale Blanche, Boulevard Tanguy Prigent, 29200, Brest, France.
LaTIM, INSERM, UMR 1101, SFR IBSAM, Avenue Foch, 29200, Brest, France.
Rheumatol Ther. 2021 Mar;8(1):457-466. doi: 10.1007/s40744-021-00283-2. Epub 2021 Feb 4.
INTRODUCTION: Ulnar tunnel syndrome at the elbow is a common pathology. The ultrasound cross-sectional area is a well-known metric widely accepted in radiology for the description of nerve entrapment. However, the pathological cut-off value remains challenging. The objectives of this study were to (1) describe the ultrasound cross-sectional area measurement of the ulnar nerve at three locations, and (2) to evaluate the inter-observer reliability by two independent ultrasonographers. METHODS: One-hundred ulnar nerves of 50 asymptomatic individuals were scanned using B-mode and power Doppler ultrasonography. The ultrasound cross-sectional area measurements of the ulnar nerve were performed at three different levels: 2 cm proximal to the epicondyle, at the level of the epicondyle, and 2 cm distal to the epicondyle. RESULTS: In our healthy population, we found 21, 24 and 7% of ultrasound cross-sectional area ulnar nerve > 8 mm, respectively, at three different levels of measurement and 4, 7, and 0% US-CSA ulnar nerve > 10 mm. The intraclass correlation coefficient measured at three different site levels were good (0.7943, 0.7509) to moderate (0.5701). CONCLUSIONS: Almost one-quarter of our healthy population had an ultrasound cross-sectional area ulnar nerve more than 8 mm and few more than 10 mm. A cut-off of ultrasound cross-sectional area ulnar nerve measurement more than 10 mm could be considered as pathological. No abnormal elbow ulnar nerve vascularization has been seen. This is the first step towards normal B-mode ulnar nerve values at the elbow to further detect pathological US findings as ulnar nerve entrapment.
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