Ulnar neuropathy at the wrist.

Area of Science:

• Neurology
• Anatomy
• Diagnostic Imaging

Background:

• Ulnar nerve entrapment at the wrist, specifically within Guyon's canal, is an uncommon condition.
• Clinical presentation can mimic more common ulnar nerve entrapment sites, such as the elbow.
• Accurate diagnosis requires a thorough understanding of ulnar nerve anatomy and potential compression sites.

Purpose of the Study:

• To report a case of ulnar nerve compression at the wrist.
• To highlight the diagnostic challenges and the utility of electrodiagnostic evaluations.
• To emphasize the importance of considering Guyon's canal as a potential site for ulnar nerve lesions.

Main Methods:

• Case report detailing clinical presentation and diagnostic workup.
• Electrophysiological studies (nerve conduction studies and electromyography) for precise localization of the lesion.
• Magnetic Resonance Imaging (MRI) to visualize the anatomical structures and identify the cause of compression.
• Surgical intervention for confirmation and treatment.

Main Results:

• The case presented with symptoms initially suggestive of ulnar nerve entrapment at the elbow.
• Electrophysiological evaluation correctly identified the ulnar nerve lesion within Guyon's canal.
• MRI revealed a ganglionic cyst compressing the ulnar nerve within Guyon's canal.
• Surgical intervention confirmed the presence of the ganglionic cyst and relieved the nerve compression.

Conclusions:

• Ulnar nerve entrapment at the wrist is uncommon and diagnostically challenging.
• Electrodiagnostic evaluations are crucial for accurate diagnosis, differentiating from other neuropathies, and identifying coexisting conditions.
• Understanding the anatomical course of the ulnar nerve is essential for effective clinical and electrodiagnostic assessment.