Sander M Pompe1, Roy Beekman. 1. Departments of Neurology and Clinical Neurophysiology, Atrium Medical Centre Heerlen, The Netherlands. sanderpompe@hotmail.com
Abstract
OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic ulnar nerve diameter, cross-sectional area (CSA) and swelling ratio measurement in ulnar neuropathy at the elbow (UNE). METHODS: Ultrasonographic diameter, CSA, and swelling ratio measurements were compared with a reference standard including clinical examination, electrophysiological studies, and follow-up in a prospective cohort of patients. All patients in whom a diagnosis of UNE was considered were eligible for the study. Reference values for ultrasonography were obtained in 73 healthy volunteers. RESULTS: Of 191 patients, 137 had UNE or probable UNE, while 54 had another condition and these were analysed as patient controls. Patients with UNE had a larger ulnar nerve diameter, CSA and swelling ratio than healthy controls and patient controls (p < 0.01). The diagnostic accuracies of these different measurements were comparable with a specificity of 78-87%, a positive predictive value of 87-90%, a sensitivity of 42-61% and negative predictive value of 37-44%. ROC-analysis for these measurements showed an area under the curve of 0.75-0.77. CONCLUSION: Ultrasonographic measurements of ulnar nerve diameter, CSA and swelling ratio have comparable diagnostic value, which was lower than reported previously. SIGNIFICANCE: Ultrasonographic ulnar nerve diameter, CSA and swelling ratio measurements are equally useful in diagnosing UNE.
OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic ulnar nerve diameter, cross-sectional area (CSA) and swelling ratio measurement in ulnar neuropathy at the elbow (UNE). METHODS: Ultrasonographic diameter, CSA, and swelling ratio measurements were compared with a reference standard including clinical examination, electrophysiological studies, and follow-up in a prospective cohort of patients. All patients in whom a diagnosis of UNE was considered were eligible for the study. Reference values for ultrasonography were obtained in 73 healthy volunteers. RESULTS: Of 191 patients, 137 had UNE or probable UNE, while 54 had another condition and these were analysed as patient controls. Patients with UNE had a larger ulnar nerve diameter, CSA and swelling ratio than healthy controls and patient controls (p < 0.01). The diagnostic accuracies of these different measurements were comparable with a specificity of 78-87%, a positive predictive value of 87-90%, a sensitivity of 42-61% and negative predictive value of 37-44%. ROC-analysis for these measurements showed an area under the curve of 0.75-0.77. CONCLUSION: Ultrasonographic measurements of ulnar nerve diameter, CSA and swelling ratio have comparable diagnostic value, which was lower than reported previously. SIGNIFICANCE: Ultrasonographic ulnar nerve diameter, CSA and swelling ratio measurements are equally useful in diagnosing UNE.
Authors: Nurcan Üçeyler; Kristina A Schäfer; Daniel Mackenrodt; Claudia Sommer; Wolfgang Müllges Journal: Front Neurol Date: 2016-03-30 Impact factor: 4.003