Ulnar Nerve Cross-Sectional Area for the Diagnosis of Cubital Tunnel Syndrome: A Meta-Analysis of Ultrasonographic Measurements
Journal
Archives of Physical Medicine and Rehabilitation
Journal Volume
99
Journal Issue
4
Pages
743-757
Date Issued
2018
Author(s)
Abstract
Objective: To examine the performance of sonographic cross-sectional area (CSA) measurements in the diagnosis of cubital tunnel syndrome (CuTS). Data Sources: Electronic databases, comprising PubMed and EMBASE, were searched for the pertinent literature before July 1, 2017. Study Selection: Fourteen trials comparing the ulnar nerve CSA measurements between participants with and without CuTS were included. Data Extraction: Study design, participants' demographic characteristics, diagnostic reference of CuTS, and methods of CSA measurement. Data Synthesis: Among different elbow levels, the between-group difference in CSA was the largest at the medial epicondyle (6.0mm2; 95% confidence interval [CI], 4.5–7.4mm2). The pooled mean CSA in participants without CuTS was 5.5mm2 (95% CI, 4.4–6.6mm2) at the arm level, 7.4mm2 (95% CI, 6.7–8.1mm2) at the cubital tunnel inlet, 6.6mm2 (95% CI, 5.9–7.2mm2) at the medial epicondyle, 7.3mm2 (95% CI, 5.6–9.0mm2) at the cubital tunnel outlet, and 5.5mm2 (95% CI, 4.7–6.3mm2) at the forearm level. The sensitivities, specificities, and diagnostic odds ratios pooled from 5 studies, using 10mm2 as the cutoff point, were.85 (95% CI,.78–.90),.91 (95% CI,.86–.94), and 53.96 (95% CI, 14.84–196.14), respectively. Conclusions: The ulnar nerve CSA measured by ultrasound imaging is useful for the diagnosis of CuTS and is most significantly different between patients and participants without CuTS at the medial epicondyle. Because the ulnar nerve CSA in healthy participants, at various locations, rarely exceeds 10mm2, this value can be considered as a cutoff point for diagnosing ulnar nerve entrapment at the elbow region. ? 2017 American Congress of Rehabilitation Medicine
SDGs
Other Subjects
cross sectional area; cubital tunnel syndrome; demography; diagnostic accuracy; echography; Embase; forearm; human; Medline; meta analysis; musculoskeletal system parameters; Review; sensitivity and specificity; ulnar nerve; adult; anatomy; anatomy and histology; cubital tunnel syndrome; diagnostic imaging; echography; elbow; female; innervation; male; middle aged; odds ratio; procedures; reference value; Adult; Anatomy, Cross-Sectional; Cubital Tunnel Syndrome; Elbow; Female; Humans; Male; Middle Aged; Odds Ratio; Reference Values; Sensitivity and Specificity; Ulnar Nerve; Ultrasonography
Publisher
W.B. Saunders
Type
review