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cubital tunnel syndrome (ulnar nerve entrapment)

Etiology: - entrapment of the ulnar nerve at the elbow Clinical manifestations: 1) paresthesias 2) Tinel's sign 3) sensory abnormalities on the ulnar side of the 4th & 5th fingers 4) progressive hand weakness - unable to hold a piece of paper between the thumb & lateral aspect of the index finger [4] 5) claw hand 6) atrophy of intrinsic hand muscles Laboratory: 1) nerve conduction study 2) electromyography Differential diagnosis: 1) C8/T1 radiculopathy 2) lower trunk brachial plexopathy 3) early motor neuron disease (amyotropic lateral sclerosis) 4) ulnar nerve entrapment at the wrist or hand Management: 1) elbow splint to prevent flexion 2) protection of elbow with elbow pad 3) anti-inflammatory agents 4) surgical decompression is rarely needed [2] - ref [3] goes straight to ulnar nerve decompression without a trial of conservative management [3]

Related

paresthesia; burning; tingling Tinel's sign ulnar nerve

General

ulnar neuropathy

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1016-18
  2. Clyman B, in: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  3. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018 - Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025
  4. Doughty CT, Bowley MP. Entrapment neuropathies of the upper extremity. Med Clin North Am 2019 Mar; 103:357 PMID: 30704687