From the Guidelines
Cubital tunnel syndrome is a condition characterized by ulnar nerve entrapment at the elbow, leading to symptoms such as numbness, tingling, and pain.
Key Characteristics
- The ulnar nerve is the nerve most commonly affected by entrapment at the elbow [ 1 ]
- Symptoms of cubital tunnel syndrome include numbness, tingling, and pain in the hand and arm [ 1 ]
- Imaging studies such as MRI and US can be used to evaluate ulnar nerve entrapment [ 1 ]
Diagnosis
- T2-weighted MR neurography is the reference standard for imaging ulnar nerve entrapment [ 1 ]
- US elbow can also be used to evaluate ulnar nerve entrapment, with high accuracy rates for assessment of cross-sectional area and nerve thickness [ 1 ]
- Dynamic US can demonstrate nerve dislocation in ulnar nerve neuropathy and snapping triceps syndrome [ 1 ]
Management
- Management of cubital tunnel syndrome may include conservative measures such as rest, activity modification, and physical therapy, as well as surgical intervention in more severe or refractory cases [ 1 ]
From the Research
Definition and Causes of Cubital Tunnel Syndrome
- Cubital tunnel syndrome (CuTS) is the compression of the ulnar nerve as it courses through the cubital tunnel near the elbow, also known as the "funny bone" 2.
- The compression of the ulnar nerve can be caused by repetitive pressure, stretching, flexion, or trauma of the elbow joint 2, 3.
- CuTS can also be caused by deformation or other processes of the elbow joint, and can be differentiated into primary and secondary forms 4.
Symptoms and Diagnosis of Cubital Tunnel Syndrome
- Symptoms of CuTS include numbness, tingling, or pain in the ring and small fingers, as well as clumsiness, hand atrophy, and weakness 2, 4, 5.
- The earliest sign of CuTS is often numbness and tingling of the ring and 5th finger 2.
- Diagnosis of CuTS can be made through physical exam using Tinel's sign, flexion-compression tests, and palpating the ulnar nerve for thickening and local tenderness 2, 4.
- Ultrasound and nerve conduction studies may also be used in combination with physical exam for diagnosis 2, 4.
Treatment Options for Cubital Tunnel Syndrome
- Conservative treatment for CuTS includes elbow splints, braces, and night-gliding exercises, and is often pursued before surgical treatment 2, 4.
- Surgical treatment options include simple in-situ decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve 2, 4, 6.
- The choice of treatment depends on the severity of the condition and the presence of any underlying conditions or complications 4, 6.