Presentation
Right arm pain, redness along the medial side for the last 3 days. There is a palpable cord-like superficial tender structure in the region of pain, swelling.
Patient Data
A subcutaneous vein along the medial side of the right arm shows a non-compressible lumen with a few internal echoes without any flow. There is echogenic perivenous subcutaneous fat.
The right cubital tunnel shows a hypoechoic structure overlying the ulnar nerve. The structure shows muscle echopattern. It extends from the medial epicondyle of the humerus to the olecranon process of the ulna. With complete flexion of the elbow, the ulnar nerve is compressed between ulnar collateral ligament (floor) and the muscle structure (roo). There is no edema of the ulnar nerve proximally
The left elbow shows similar extra muscle overlying the ulnar nerve. There is ulnar nerve compression with complete flexion of the left elbow. There is no edema of the ulnar nerve proximally.
Case Discussion
The case shows characteristic history (pain, redness aligned to the arm), examination findings (palpable cord-like structure in subcutaneous plane, skin redness) and ultrasound findings (a subcutaneous vein showing non-compressible lumen with internal echoes, perivenous echogenic fat) of superficial thrombophlebitis.
There is an incidental finding of anconeus epitrochlearis which is present on both sides. There is no ulnar nerve edema on either side.
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