Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Skeletal Radiology

18.05.2024 | Review Article

Cubital tunnel syndrome: anatomy, pathology, and imaging

verfasst von: Mohsin Hussein, Manasa Mayukha Hanumanthu, Kapil Shirodkar, Vijay Ram Kumar Papineni, Hasan Rahij, Sandeep Velicheti, Karthikeyan P. Iyengar, Rajesh Botchu

Erschienen in: Skeletal Radiology

Einloggen, um Zugang zu erhalten

Abstract

Cubital tunnel syndrome (CuTS) is the second most common peripheral neuropathy in the upper limb. It occurs due to ulnar nerve compression within the fibro-osseous cubital tunnel at the elbow joint. Although CuTS is typically diagnosed clinically and with electrodiagnostic studies, the importance of imaging in evaluating the condition is growing. Knowing the typical imaging findings of ulnar nerve entrapment is necessary for precise diagnosis and proper treatment. In this article, we focus on the clinical features, workup and complex imaging of the “anatomic” cubital tunnel and relevant pathological entities.
Literatur
1.
2.
Robertson C, Saratsiotis J. A review of compressive ulnar neuropathy at the elbow. J Manipulative Physiol Ther. 2005;28(5):345.PubMedCrossRef
3.
Bednar MS, Blair SJ, Light TR. Complications of the treatment of cubital tunnel syndrome. Hand Clin. 1994;10(1):83.PubMedCrossRef
4.
An TW, Evanoff BA, Boyer MI, Osei DA. The prevalence of cubital tunnel syndrome: a cross-sectional study in a US metropolitan cohort. JBJS. 2017;99(5):408–16.CrossRef
5.
Granger A, Sardi JP, Iwanaga J, Wilson TJ, Yang L, Loukas M, Oskouian RJ, Tubbs RS. Osborne’s ligament: a review of its history, anatomy, and surgical importance. Cureus. 2017;9(3):e1080.
6.
Agarwal A, Chandra A, Jaipal U, Saini N. Imaging in the diagnosis of ulnar nerve pathologies—a neoteric approach. Insights Imaging. 2019;10:1–2.CrossRef
7.
Won HS, Han SH, Oh CS, Chung IH, Kim SM, Lim SY. Topographic relationship between the medial intermuscular septum and the ulnar nerve in the upper arm. J Neurosurg. 2011;114(6):1534–7.PubMedCrossRef
8.
Macchi V, Tiengo C, Porzionato A, Stecco C, Sarasin G, Tubbs S, Maffulli N, De Caro R. The cubital tunnel: a radiologic and histotopographic study. J Anat. 2014;225(2):262–9.PubMedPubMedCentralCrossRef
9.
James J, Sutton LG, Werner FW, Basu N, Allison MA, Palmer AK. Morphology of the cubital tunnel: an anatomical and biomechanical study with implications for treatment of ulnar nerve compression. J Hand Surg. 2011;36(12):1988–95.CrossRef
10.
O’Driscoll SW, Horii EM, Carmichael SW, Morrey BF. The cubital tunnel and ulnar neuropathy. J Bone Joint Surg Br Volume. 1991;73(4):613–7.CrossRef
11.
Martinoli C, Bianchi S, Gandolfo N, Valle M, Simonetti S, Derchi LE. US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. Radiographics. 2000;20(suppl_1):S199-217.PubMedCrossRef
12.
13.
Mezian K, Jačisko J, Kaiser R, Machač S, Steyerová P, Sobotová K, Angerová Y, Naňka O. Ulnar neuropathy at the elbow: from ultrasound scanning to treatment. Front Neurol. 2021;14(12):661441.CrossRef
14.
Said J, Abboudi J, Gallant G, Jones C, Kirkpatrick W, Liss F, Rivlin M, Takei RR, Wang M, Silverman M, Foltz C. Prospective evaluation of sleep improvement after cubital tunnel decompression surgery. J Shoulder Elbow Surg. 2019;28(5):e144–9.PubMedCrossRef
15.
Hrehova L, Mezian K. Non-pharmacologic treatment of insomnia in primary care settings. Int J Clin Pract. 2021;75(6):e14084.PubMedCrossRef
16.
Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. J Hand Surg. 2008;33(9):1518–24.CrossRef
17.
Ochi K, Horiuchi Y, Tanabe A, Waseda M, Kaneko Y, Koyanagi T. Shoulder internal rotation elbow flexion test for diagnosing cubital tunnel syndrome. J Shoulder Elbow Surg. 2012;21(6):777–81.PubMedCrossRef
18.
Mcgowan AJ. The results of transposition of the ulnar nerve for traumatic ulnar neuritis. J Bone Joint Surg Br Volume. 1950;32(3):293–301.CrossRef
19.
20.
Chung T, Prasad K, Lloyd TE. Peripheral neuropathy: clinical and electrophysiological considerations. Neuroimaging Clin. 2014;24(1):49–65.CrossRef
21.
22.
American Association of Electrodiagnostic Medicine. Guidelines in electrodiagnostic medicine. Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow. Muscle Nerve Suppl. 1999;8:S171-205.
23.
Shinohara I, Inui A, Mifune Y, Nishimoto H, Yamaura K, Mukohara S, Yoshikawa T, Kato T, Furukawa T, Hoshino Y, Matsushita T. Diagnosis of cubital tunnel syndrome using deep learning on ultrasonographic images. Diagnostics. 2022;12(3):632.PubMedPubMedCentralCrossRef
24.
Stoll G, Bendszus M, Perez J, Pham M. Magnetic resonance imaging of the peripheral nervous system. J Neurol. 2009;256(7):1043–51.PubMedCrossRef
25.
Chang KV, Wu WT, Han DS, Özçakar L. Ulnar nerve cross-sectional area for the diagnosis of cubital tunnel syndrome: a meta-analysis of ultrasonographic measurements. Arch Phys Med Rehabil. 2018;99(4):743–57.PubMedCrossRef
26.
Boers N, Martin E, Mazur M, Krijgh DD, Vlak MHM, de Ruiter GCW, et al. Sonographic normal values for the cross-sectional area of the ulnar nerve: a systematic review and meta-analysis. J Ultrasound. 2023;26(1):81–8.PubMed
27.
Keen NN, Chin CT, Engstrom JW, Saloner D, Steinbach LS. Diagnosing ulnar neuropathy at the elbow using magnetic resonance neurography. Skeletal Radiol. 2012;41:401–7.PubMedCrossRef
28.
Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology. 2009;252(1):148–56.PubMedCrossRef
29.
Griffiths TT, Flather R, Teh I, Haroon HA, Shelley D, Plein S, Bourke G, Wade RG. Diffusion tensor imaging in cubital tunnel syndrome. Sci Rep. 2021;11(1):14982.PubMedPubMedCentralCrossRef
30.
Martinoli C, Bianchi S, Pugliese F, Bacigalupo L, Gauglio C, Valle M, Derchi LE. Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound. 2004;32(9):438–50.PubMedCrossRef
31.
Agarwal A, Chandra A, Jaipal U, Bagarhatta M, Mendiratta K, Goyal A, Kumar R, Mangalhara N. Can imaging be the new yardstick for diagnosing peripheral neuropathy?—a comparison between high resolution ultrasound and MR neurography with an approach to diagnosis. Insights Imaging. 2019;10:1–3.CrossRef
32.
Okamoto M, Abe M, Shirai H, Ueda N. Morphology and dynamics of the ulnar nerve in the cubital tunnel: observation by ultrasonography. J Hand Surg: British & European Volume. 2000;25(1):85–9.CrossRef
33.
Yoon JS, Walker FO, Cartwright MS. Ultrasonographic swelling ratio in the diagnosis of ulnar neuropathy at the elbow. Muscle Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2008;38(4):1231–5.CrossRef
34.
Bayrak AO, Bayrak IK, Turker H, Elmali M, Nural MS. Ultrasonography in patients with ulnar neuropathy at the elbow: comparison of cross-sectional area and swelling ratio with electrophysiological severity. Muscle Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2010;41(5):661–6.CrossRef
35.
Park GY, Kim JM, Lee SM. The ultrasonographic and electrodiagnostic findings of ulnar neuropathy at the elbow. Arch Phys Med Rehabil. 2004;85(6):1000–5.PubMedCrossRef
36.
Wiesler ER, Chloros GD, Cartwright MS, Shin HW, Walker FO. Ultrasound in the diagnosis of ulnar neuropathy at the cubital tunnel. J Hand Surg. 2006;31(7):1088–93.CrossRef
37.
Jacobson JA, Jebson PJ, Jeffers AW, Fessell DP, Hayes CW. Ulnar nerve dislocation and snapping triceps syndrome: diagnosis with dynamic sonography—report of three cases. Radiology. 2001;220(3):601–5.PubMedCrossRef
38.
Childress HM. Recurrent ulnar-nerve dislocation at the elbow. Clin Orthop Relat Res. 1975;1976–2007(108):168–73.CrossRef
39.
Kim JH, Won SJ, Rhee WI, Park HJ, Hong HM. Diagnostic cutoff value for ultrasonography in the ulnar neuropathy at the elbow. Ann Rehabil Med. 2015;39(2):170.PubMedPubMedCentralCrossRef
40.
Jacob D, Creteur V, Courthaliac C, Bargoin R, Sassus B, Bacq C, Rozies JL, Cercueil JP, Brasseur JL. Sonoanatomy of the ulnar nerve in the cubital tunnel: a multicentre study by the GEL. Euro Radiol. 2004;14:1770–3.CrossRef
41.
Sanjuan-Cervero R, Peña-Molina F, Franco-Ferrando N. Dynamic compression of the ulnar nerve associated with the anconeus epitrochlearis muscle: do we really know everything? J Hand Surg Glob Online. 2023;5(4):585–7.PubMedCrossRef
42.
Masear VR, Hill JJ, Cohen SM. Ulnar compression neuropathy secondary to the anconeus epitrochlearis muscle. J Hand Surg Am. 1988;13(5):720–4.PubMedCrossRef
43.
Maslow JI, Johnson DJ, Block JJ, Lee DH, Desai MJ. Prevalence and clinical manifestations of the anconeus epitrochlearis and cubital tunnel syndrome. Hand (N Y). 2020;15(1):69–74.PubMedCrossRef
44.
Kato H, Hirayama T, Minami A, Iwasaki N, Hirachi K. Cubital tunnel syndrome associated with medial elbow Ganglia and osteoarthritis of the elbow. J Bone Joint Surg Am. 2002;84(8):1413–9.PubMedCrossRef
45.
Sharma RR, Pawar SJ, Delmendo A, Mahapatra AK. Symptomatic epineural ganglion cyst of the ulnar nerve in the cubital tunnel: a case report and brief review of the literature. J Clin Neurosci. 2000;7(6):542–3.PubMedCrossRef
46.
Mueller T, Barthel T, Cramer A, Werner A, Gohlke F. Primary synovial chondromatosis of the elbow. J Shoulder Elbow Surg. 2000;9(4):319–22.PubMedCrossRef
47.
Kiritsi O, Tsitas K, Grollios G. A case of idiopathic bursal synovial chondromatosis resembling rheumatoid arthritis. Hippokratia. 2009;13(1):61–3.PubMedPubMedCentral
48.
Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: radiologic-pathologic correlation. Radiographics. 2004;24(5):1477–81.PubMedCrossRef
49.
Lin J, Martel W. Cross-sectional imaging of peripheral nerve sheath tumors: characteristic signs on CT, MR imaging, and sonography. AJR Am J Roentgenol. 2001;176(1):75–82.PubMedCrossRef
50.
Rafailidis V, Kaziani T, Theocharides C, Papanikolaou A, Rafailidis D. Imaging of the malignant peripheral nerve sheath tumour with emphasis on ultrasonography: correlation with MRI. J Ultrasound. 2014;17(3):219–23.PubMedPubMedCentralCrossRef
51.
Hamazaki S, Fujiwara K, Okada S. Intraneural perineurioma involving the ulnar nerve. Pathol Int. 2004;54(5):371–5.PubMedCrossRef
52.
Yang H, Dong Y, Wang Z, Lai J, Yao C, Zhou H, et al. Traumatic neuromas of peripheral nerves: diagnosis, management and future perspectives. Front Neurol. 2022;13:1039529.PubMedCrossRef
53.
Henry M. Management of Iatrogenic ulnar nerve transection. J Hand Microsurg. 2015;7(1):173–6.PubMedCrossRef
54.
Li P, Lou D, Lu H. The cubital tunnel syndrome caused by intraneural ganglion cyst of the ulnar nerve at the elbow: a case report. BMC Neurol. 2018;18(1):217.PubMedPubMedCentralCrossRef
55.
Chang WK, Li YP, Zhang DF, Liang BS. The cubital tunnel syndrome caused by the intraneural or extraneural ganglion cysts: case report and review of the literature. J Plast Reconstr Aesthet Surg. 2017;70(10):1404–8.PubMedCrossRef
56.
Ariyaratne S, Pathak G, Iyengar K, Botchu R, Shah A. A rare case of an intraneural ganglion cyst of the median nerve. J Ultrason. 2023;23(94):e161–4.PubMedPubMedCentralCrossRef
57.
Vidoni A, McLoughlin E, James SL, Botchu R. Intra-neural ganglion cyst of the lateral dorsal cutaneous nerve: an uncommon cause of lateral ankle pain. J Ultrasound. 2020;23(1):81–6.PubMedCrossRef
58.
Kawahara Y, Yamaguchi T, Honda Y, Tomita Y, Uetani M. The ulnar nerve at elbow extension and flexion: assessment of position and signal intensity on MR images. Radiology. 2016;280(2):483–92.PubMedCrossRef
59.
Debkowska MP, Cotterell IH, Riley AJ. Case report: acute cubital tunnel syndrome in a hemophiliac patient. SAGE Open Med Case Rep. 2019;7:2050313X18824814.PubMedPubMedCentral
60.
Chadwick N, Morag Y, Smith BW, Yablon C, Kim SM, Yang LJ. Imaging appearance following surgical decompression of the ulnar nerve. Br J Radiol. 2019;92(1094):20180757.PubMedCrossRef
61.
Rhodes NG, Howe BM, Frick MA, Moran SL. MR imaging of the postsurgical cubital tunnel: an imaging review of the cubital tunnel, cubital tunnel syndrome, and associated surgical techniques. Skeletal Radiol. 2019;48(10):1541–54.PubMedCrossRef
62.
Dellon AL. Review of treatment results for ulnar nerve entrapment at the elbow. J Hand Surg Am. 1989;14(4):688–700.PubMedCrossRef
63.
Caetano EB, Sabongi Neto JJ, Vieira LA, Caetano MF. The arcade of Struthers: an anatomical study and clinical implications. Rev Bras Ortop. 2017;52(3):331–6.PubMedPubMedCentralCrossRef
64.
Bartels RH, Grotenhuis JA, Kauer JM. The arcade of Struthers: an anatomical study. Acta Neurochir (Wien). 2003;145(4):295–300 discussion.PubMedCrossRef
65.
Siqueira MG, Martins RS. The controversial arcade of Struthers. Surg Neurol. 2005;64(Suppl 1):S17-20 discussion S1:-1.CrossRef
66.
Spinner M, Kaplan EB. The relationship of the ulnar nerve to the medial intermuscular septum in the arm and its clinical significance. Hand. 1976;8(3):239–42.PubMedCrossRef
67.
Childress HM. Recurrent ulnar-nerve dislocation at the elbow. Clin Orthop Relat Res. 1975;108:168–73.CrossRef
68.
Kang S, Yoon JS, Yang SN, Choi HS. Retrospective study on the impact of ulnar nerve dislocation on the pathophysiology of ulnar neuropathy at the elbow. PeerJ. 2019;7:e6972.PubMedPubMedCentralCrossRef
69.
Jacobson JA, Jebson PJ, Jeffers AW, Fessell DP, Hayes CW. Ulnar nerve dislocation and snapping triceps syndrome: diagnosis with dynamic sonography–report of three cases. Radiology. 2001;220(3):601–5.PubMedCrossRef
70.
Spinner RJ, Goldner RD. Snapping of the medial head of the triceps and recurrent dislocation of the ulnar nerve. Anatomical and dynamic factors. J Bone Joint Surg Am. 1998;80(2):239–47.PubMedCrossRef
71.
Bordes SJ, Jenkins S, Bang K, Turgut M, Iwanaga J, Loukas M, et al. Ulnar nerve subluxation and dislocation: a review of the literature. Neurosurg Rev. 2021;44(2):793–8.PubMedCrossRef
72.
Jensen A, Kaerlev L, Tüchsen F, Hannerz H, Dahl S, Nielsen PS, et al. Locomotor diseases among male long-haul truck drivers and other professional drivers. Int Arch Occup Environ Health. 2008;81(7):821–7.PubMedCrossRef
73.
Ruess L, O’Connor SC, Cho KH, Hussain FH, Howard WJ, Slaughter RC, et al. Carpal tunnel syndrome and cubital tunnel syndrome: work-related musculoskeletal disorders in four symptomatic radiologists. AJR Am J Roentgenol. 2003;181(1):37–42.PubMedCrossRef
74.
Finsterer J. Ulnar neuropathy at the elbow due to unusual sleep position. Eur J Neurol. 2000;7(1):115–7.PubMedCrossRef
75.
Michael AE, Young P. Is triceps hypertrophy associated with ulnar nerve luxation? Muscle Nerve. 2018;58(4):523–7.PubMedCrossRef
Metadaten
Titel
Cubital tunnel syndrome: anatomy, pathology, and imaging
verfasst von
Mohsin Hussein
Manasa Mayukha Hanumanthu
Kapil Shirodkar
Vijay Ram Kumar Papineni
Hasan Rahij
Sandeep Velicheti
Karthikeyan P. Iyengar
Rajesh Botchu
Publikationsdatum
18.05.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-024-04705-4

Neu im Fachgebiet Radiologie

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise