What are the limitations of ultrasonography in the evaluation of ulnar neuropathy?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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A further consideration is the comparison of the localizations derived from both sonographic and electrophysiological methods. Simon et al compared the lesion localization obtained by careful short-segment neurophysiological inching studies with that obtained by ultrasonographic methods. [122] For the larger segment across the entire elbow, the overall drop in conduction velocity correlated well with the maximum cross-sectional area (CSA) and maximal degree of hypoechoic fraction. However, on the short segments in patients whose lesion was apparently at the medical epicondyle as judged by neurophysiological methods, the maximal songraphic abnormalities were detected both slightly proximally and slightly distally to the medial epicondyle. It was concluded, therefore, that the ultrasonographic images may be detecting secondary changes adjacent to the major site of damage.

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