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Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
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Published on: January 11, 2019

Avoiding false-negative nerve conduction study in ulnar neuropathy at the elbow.

Sun Jae Won1, Joon Shik Yoon, Jun Yeon Kim

  • 1Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Guro Dong, Seoul, South Korea.

Muscle & Nerve
|September 17, 2011
PubMed
Summary

Ulnar nerve displacement at the elbow can lead to inaccurate nerve conduction velocity measurements. Using ultrasonography to correct these measurements improves diagnostic accuracy for ulnar neuropathy.

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Area of Science:

  • Neurology
  • Electrodiagnostic Medicine
  • Medical Imaging

Background:

  • Ulnar nerve displacement at the elbow can artificially inflate nerve conduction velocity measurements.
  • This overestimation may lead to false-negative results when applying the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) criteria.

Purpose of the Study:

  • To investigate the impact of ulnar nerve displacement on electrodiagnostic criteria for ulnar neuropathy.
  • To determine if ultrasonography can correct for overestimations in nerve conduction velocity.

Main Methods:

  • Studied 9 patients with ulnar neuropathy at the elbow and confirmed ulnar nerve displacement via ultrasonography.
  • Measured nerve conduction distance using anatomical landmarks and then re-estimated it using ultrasonography.

Main Results:

  • Corrected overestimated ulnar nerve conduction velocity by an average of 7.9 m/s.
  • Three cases initially meeting none of the AANEM criteria subsequently met two criteria after velocity correction.

Conclusions:

  • Ultrasonography is crucial for identifying ulnar nerve displacement, especially when electrodiagnostic findings are equivocal.
  • Accurate measurement of the ulnar nerve segment is vital for correct diagnosis of ulnar neuropathy at the elbow.