Ulnar Nerve Compression
Purpose: To determine the presence of cubital tunnel syndrome.
Test Position: Standing.
Performing the Test: The patient is standing and the examiner passively flexes the involved elbow to approximately 20 degrees. Next the examiner places a firm pressure on the ulnar nerve just proximal to the cubital tunnel and maintains the pressure for 60 seconds. A positive test is if the patient reports numbness and/or tingling in an ulnar nerve distribution (ulnar aspect of hand).
Diagnostic Accuracy: Sensitivity: .89; Specificity: .98; -LR:.11, +LR: 44.5
Importance of Test: The ulnar nerve passes in front of the medial head of the triceps brachii and into the bony groove on the humerus (Cubital tunnel). It extends from the medial epicondyle to olecranon and perpendicular to the flexor carpi ulnaris aponeurosis. The sustained position of elbow flexion can place a stretch on the ulnar nerve due to the position of the nerve relative to the bones, which reproduces the symptoms of ulnar nerve compression. In some patients, the ulnar nerve can flip in and out of the cubital tunnel, irritating the nerve. This test looks to reproduce that irritation by applying pressure to the nerve for a sustained period of time.
Note: these tests should only be used by properly trained health care practitioners
Test Position: Standing.
Performing the Test: The patient is standing and the examiner passively flexes the involved elbow to approximately 20 degrees. Next the examiner places a firm pressure on the ulnar nerve just proximal to the cubital tunnel and maintains the pressure for 60 seconds. A positive test is if the patient reports numbness and/or tingling in an ulnar nerve distribution (ulnar aspect of hand).
Diagnostic Accuracy: Sensitivity: .89; Specificity: .98; -LR:.11, +LR: 44.5
Importance of Test: The ulnar nerve passes in front of the medial head of the triceps brachii and into the bony groove on the humerus (Cubital tunnel). It extends from the medial epicondyle to olecranon and perpendicular to the flexor carpi ulnaris aponeurosis. The sustained position of elbow flexion can place a stretch on the ulnar nerve due to the position of the nerve relative to the bones, which reproduces the symptoms of ulnar nerve compression. In some patients, the ulnar nerve can flip in and out of the cubital tunnel, irritating the nerve. This test looks to reproduce that irritation by applying pressure to the nerve for a sustained period of time.
Note: these tests should only be used by properly trained health care practitioners
References:
Neumann, Donald. "Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation." 2nd edition. St. Louis, MO: Mosby Elsevier, 2010. 193. Print.
Novak CB, Lee GW, Mackinnon SE, Lay L. "Provocative testing for cubital tunnel syndrome." J Hand Surg (AM) 1994 September; 19(5):817-20.
Neumann, Donald. "Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation." 2nd edition. St. Louis, MO: Mosby Elsevier, 2010. 193. Print.
Novak CB, Lee GW, Mackinnon SE, Lay L. "Provocative testing for cubital tunnel syndrome." J Hand Surg (AM) 1994 September; 19(5):817-20.
