Presentation
Right 4th and 5th fingers weakness, numbness for the last few weeks. No trauma.
Patient Data
Ulnar nerve severe compression at the elbow. The nerve cross-sectional area: at the distal arm 13.2 mm2 and the elbow 2.6 mm2. A thin-walled, anechoic, lobulated, avascular cyst (about 20 x 7 x 3 mm) between the compressed nerve and the underlying medial joint line. Normal nerve distal to the elbow. Intact common flexor tendon and anterior band of the ulnar collateral ligament.
Fatty infiltration of the themar muscles (deep head of the flexor pollicis brevis and adductor pollicis brevis) lying deep to the flexor pollicis longus tendon. Muscles superficial to the flexor pollicus longus tendon are spaced.
Reduction of radiocapitellar space. Radial head osteophytes. No bone injury/ bone lesion.
A drawing representing the pathology.
Case Discussion
The patient with ulnar neuropathy was referred for an ultrasound evaluation of the ulnar nerve. There is severe compression of the ulnar nerve at the cubital tunnel with a ganglion cyst from the medial elbow joint line, and degenerative disease of the elbow joint (x-ray changes) with secondary changes in deeper muscles of the thenar eminence of the hand.
A companion case: https://doi.org/10.53347/rID-191029
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