Monograph: Evidence-based guideline: Neuromuscular ultrasound for the diagnosis of ulnar neuropathy at the elbow
Introduction/Aims: The purpose of this literature review is to develop an evidence-based guideline for the use of neuromuscular ultrasound in the diagnosis of ulnar neuropathy at the elbow (UNE). The proposed research question was: “In patients with suspected UNE, does ulnar nerve enlargement as measured with ultrasound accurately identify those patients with UNE?”
Methods: A systematic review and meta-analysis was performed, and studies were classified according to American Academy of Neurology criteria for rating articles for diagnostic accuracy.
Results: Based on Class I evidence in four studies, it is probable 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.
Recommendation: For patients with symptoms and signs suggestive of ulnar neurop-athy, clinicians should offer ultrasonographic measurement of ulnar nerve cross-sectional area or diameter to confirm the diagnosis and localize the site of compres-sion (Level B).
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DISCLOSURE INFORMATION
All conflicts of interest have been resolved according to ACCME standards. All authors/planners of this activity had nothing to disclose.
CREDIT DESIGNATION The AANEM designates this enduring material for a maximum of 2.0
AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 02/15/2025.
Author
1American Association of Neuromuscular & Electrodiagnostic Medicine, Rochester, Minnesota, USA
2Department of Neurology, Neuromuscular Center, Cleveland Clinic, Cleveland, Ohio, USA
3Department of Neurology, Akron Children's Hospital, Akron, Ohio, USA
4Department of Neurology, Neuromuscular Division, Beth Israel Deaconess Medical Center, Boston, Ohio, USA
5Department of Neurology, Zuyderland Medisch Centrum, Sittard-Geleen, The Netherlands
6Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, Florida, USA
7Neurological Institute, University Hospitals, Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA 8Department of Physical Medicine and Rehabilitation, Chicago Medical School, North Chicago, Illinois, USA
9Michigan Medicine, Ann Arbor VA Health System, Ann Arbor, Michigan, USA
10Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA