Two Cases of Doppler Sonography for Intraneural Vascularity of Ulnar Neuropathy at the Elbow: Before and After Surgery.

The finding of an intraneural blood flow (IBF) signal on Doppler sonography (DS) in non-surgical cases is interpreted in several ways and usually represents a pathologic condition with entrapment neuropathy. There have been no reports of the IBF signal on DS after surgery for ulnar neuropathy at the elbow (UNE). IBF was investigated before and after surgery in two cases diagnosed with UNE before surgery and confirmed after surgery. Both underwent electrodiagnostic (EDX) studies, grey scale sonography (GS), and DS before and after surgery and were diagnosed as having UNE by EDX study and GS. On DS, an IBF signal was not detected in both cases before surgery. After surgery, both cases improved their clinical and EDX findings, and an IBF signal and pulsatility were detected on DS. With respect to vascular problems, recovering venous and arterial blood supplies and dilated vessels would show much more blood flow during recovery of the affected ulnar nerve site following decompression surgery. The IBF signal would not always implicate pathology. When assessing recovery from UNE after surgery, it may be useful to evaluate intraneural vascularity at the affected site with DS.