The Diagnostic and Prognostic Role of Ultrasonography in Cubital Tunnel Syndrome: Results on a Consecutive Series of 100 Patients.

BACKGROUND AND

OBJECTIVES

High-resolution ultrasonography (US) has become increasingly popular in cubital tunnel syndrome (CubTS). In this article, we confirmed the diagnostic role of US in a large and homogeneous cohort of patients. Our primary aim was to analyze the predictive role of US findings. By systematically re-evaluating neurosonographic abnormalities over time, we also sought to assess the role of US during follow-up.

METHODS

Patients diagnosed with CubTS based on clinical, electrophysiological, and sonography findings and operated on for in situ decompression of the ulnar nerve (UN) at the elbow using the standard surgical technique between 2015 and 2024 were enrolled in this study. Clinical, US, and electrodiagnostic examination data at diagnosis and follow-up were retrospectively analyzed.

RESULTS

One hundred patients were enrolled. Preoperatively, we found a negative correlation between UN motor conduction velocity (MCV) and cross-sectional area (CSA) at the precubital ( P < .001) and cubital ( P < .001) levels. The mean follow-up was 8.5 months. Clinical outcome defined by the Bishop scale was favorable in 68 patients and poor in 32. At multivariate logistic analysis, preoperative MCV ( P < .0001), cubital UN CSA ( P = .006), and postcubital CSA ( P < .0001) resulted as independent predictors for surgical outcomes. At follow-up, multivariate logistic analysis confirmed the inverse relationship between postoperative cubital CSA and Bishop score ( P = .0062) and the direct relationship between postoperative MCV and the clinical outcome ( P = .0026).

CONCLUSION

US allows the depiction of morphological modifications because of chronic nerve compression in CubTS, both in the preoperative and postoperative period: precubital and cubital CSAs provide accurate diagnostic information; postcubital CSA could be considered a good predictor of clinical outcome; postoperative cubital CSA seems to provide important information regarding the UN recovery during follow-up.