AANEM Practice Topic: Evidence-based guideline: Neuromuscular ultrasound for the diagnosis of ulnar neuropathy at the elbow-Article

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This document is an evidence-based guideline on the use of neuromuscular ultrasound for the diagnosis of ulnar neuropathy at the elbow (UNE). The guideline was developed based on a systematic review and meta-analysis of relevant studies. The results of the review indicate that neuromuscular ultrasound measurement of the ulnar nerve at the elbow, either of diameter or cross-sectional area (CSA), is accurate for the diagnosis of UNE. Based on this evidence, the guideline recommends that clinicians offer ultrasonographic measurement of ulnar nerve CSA or diameter to confirm the diagnosis and localize the site of compression in patients with symptoms and signs suggestive of ulnar neuropathy. The guideline also highlights the importance of performing and interpreting neuromuscular ultrasound by clinicians experienced in the technique. The document provides recommendations for future research, including the need for a standardized research definition for UNE, a standardized protocol for using neuromuscular ultrasound, and studies on the relative benefit, harm, and cost of different diagnostic tests for UNE. The guideline emphasizes that neuromuscular ultrasound should be used as an adjunct to clinical examination and electrodiagnostic studies, and should not replace these methods of evaluation.

Keywords

neuromuscular ultrasound

ulnar neuropathy at the elbow

diagnosis

evidence-based guideline

systematic review

meta-analysis

ulnar nerve measurement

cross-sectional area

site of compression

clinicians experienced in ultrasound