Comparative Analysis of Ultrasound and Electrophysiological Examination in Ulnar Neuropathy at the Elbow

110 ulnar nerves were examined in 88 patients with ulnar neuropathology at the elbow. Cross-section area was assessed at different levels of the ulnar nerve. 141 ulnar nerves were examined in 91 patients of the control group. There were following injury degrees according to the electroneuromyography: mild (n = 23), moderate (n = 37), severe (n = 27), and extreme (n = 23). In patients of the control group (n = 141) nerve conduction was normal. Cross-section area was measured at antebrachium (S1), at the level of cubital tunnel (S2), at the level of condylar groove (S3), just proximal to the medial humeral epicondyle (S4), at middle part of brachium (S5). Good correlation was established between severity of neuropathy and cross-section area measured at S2, S3, and S4 levels (r = 0.58, 0.68, and 0.64 respectively, P < 0.05). The highest correlation was obtained for maximum cross-section area value at S2-S4 segment (r = 0.76, P < 0.05). A negative correlation was revealed between cross-section area and motor nerve conduction velocity at ulnar nerve segment (r = -0.74, P < 0.05). The cut-off value of cross-section area at S2-S4 segment was 12 mm² (normal value - ≤12 mm², pathology - >12 mm²; sensitivity - 84%, specificity - 95%, accuracy - 90%, AUC - 0.928). The cut-off value equal to 18 mm² was assessed to differentiate the injury type (demyelinating nerve lesion - ≤18 mm², axonal involvement - >18 mm²; sensitivity - 60%, specificity - 86%, accuracy - 74%, AUC - 0.779).

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