Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurophysiology

Background: Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy after entrapment of the median nerve. Ultrasonography is an evolving tool in the evaluation of peripheral nervous system, especially entrapment neuropathies. Objective: To investigate normative values of mixed nerve conduction study of the ulnar nerve at the elbow and to assess the role of ultrasonography in diagnosing and localizing ulnar neuropathy at the elbow. Methods: Case control study was carried on 47 clinically affected ulnar nerves and 80 clinically non affected ulnar nerves. All subjects were subjected to routine and mixed nerve conduction studies (NCSs) of the ulnar nerve. Ultrasonography (US) examination to measure the maximum cross sectional area (CSA-max) of the ulnar nerve at the elbow. Results: The cutoff value of mixed nerve conduction velocity for the below elbow- above elbow segment was {u2264} 49 m/s. The cutoff value of (CSA-max) of the ulnar nerve found at 2.5 cm distal to the sulcus was >10.5 mm2. The sensitivity of routine (NCSs), mixed (NCSs) and (US) in diagnosing UNE measured versus clinical diagnosis were 70.2%, 78.7% and 82.9% respectively. The combined sensitivity and specificity of the routine and mixed (NCSs) in diagnosis of UNE were 93.9% and 55.2% respectively, while the combined sensitivity and specificity of the routine (NCSs) and (US) in diagnosis of UNE were 95% and 58.2% respectively

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