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Cubital tunnel syndrome
What is cubital tunnel syndrome?
The cubital tunnel is located at the inner aspect of the elbow joint. It provides passage to a certain nerve (called the ulnar nerve). Various causes can result in pressure upon the ulnar nerve in this area resulting in pain and numbness at the inner aspect of the forearm and to the little and ring fingers. Examples include ganglion cysts (small fluid sacs that usually come off the joint) and osteophytes (small bony spurs resulting from wear and tear). Another cause for ulnar nerve irritation at the cubital tunnel is when the ulnar nerve is unstable and dislocates outside the cubital tunnel on forearm movements. This condition is referred to as “ulnar nerve subluxation/dislocation”. The patient may feel snapping at the inside of the elbow when the nerve dislocates, associated with pain and numbness at the inner aspect of the forearm and the little and ring fingers.
How to diagnose cubital tunnel syndrome?
Ultrasound examination is very useful for assessing the ulnar nerve for any thickening or changes that indicate nerve inflammation or irritation. It can also assess for any local cause for pressure upon the nerve as sometimes there are small sacs of fluid (called ganglion cysts) or small bony spurs (called osteophytes) that can get close to the nerve and exert pressure on it. In addition, ultrasound examination is extremely useful to perform a dynamic assessment of the ulnar nerve at the level of the cubital tunnel to assess for ulnar nerve dislocation.
Snapping ulnar nerve. The ulnar nerve is thickened and seen snapping outside the cubital tunnel on dynamic ultrasound assessment.
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