Patient referred by physiatry for diagnostic musculoskeletal ultrasound on L elbow. The patient had undergone a tricep tendon repair in the last year and complained of pain and neurologic symptoms distal to left elbow. Additionally, the patient complained of hand weakness upon manual muscle testing of ulnar innervated muscles. The patient did not complain of any neck pain or radicular symptoms.
EMG/NCV of the left upper extremity was normal for both sensory and motor responses.
Diagnostic musculoskeletal ultrasound was performed and did not visual any subluxation of the ulnar nerve with active range of motion of the elbow. Cross sectional area in the cubital tunnel was 11.34 mm which was pathological and above the norm of 10mm. Enlargement of the nerve in short and long axis was able to be seen.
This case demonstrates the ability of diagnostic musculoskeletal ultrasound to diagnose cubital tunnel syndrome with ulnar nerve entrapments. By measuring cross-sectional area of the nerve in the cubital tunnel and assessing the dynamic active range of motion of the elbow, valuable information can be obtained to help direct patient care
Doctor of Physical Therapy, Registered in Musculoskeletal Sonography, Certified Orthopedic Manual Therapist, Certified Lymphedema Therapist, Certified in Vestibular Assessment and Management, and Founder of Mobile Therapy Services
More Cases from Charles Stevens
