Ulnar Neuropathy at the Wrist


Joseph H. Feinberg, MD

Physiatrist-in-Chief, Hospital for Special Surgery
Co-Medical Director, Center for Brachial Plexus and Traumatic Nerve Injury
Associate Professor of Rehabilitation Medicine, Weill Cornell Medical College

Scott W. Wolfe, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Chief Emeritus of the Hand and Upper Extremity Service, Hospital for Special Surgery
Director, Center for Brachial Plexus and Traumatic Nerve Injury
Professor of Orthopedic Surgery, Weill Cornell Medical College

 

Carisa Pearce
Physical Medicine and Rehabilitation, New York Presbyterian Hospital

Abstract

A case of ulnar nerve compression at the wrist within Guyon’s canal is reported. The clinical presentation initially appeared consistent with an ulnar nerve entrapment at the elbow. The true diagnosis of an ulnar sensorimotor nerve lesion occurring within the canal of Guyon was made electrophysiologically. Magnetic resonance imaging demonstrated compression of the nerve within the canal by a ganglionic cyst, which was confirmed by surgical intervention. Ulnar nerve entrapment at the wrist is uncommon and difficult to diagnose; therefore, it is important to understand the nerve’s anatomical course and distribution to allow for accurate diagnosis by clinical and electrodiagnostic evaluations. Electrodiagnosis is an important tool in identifying ulnar nerve lesions at the wrist while excluding other disorders in the differential and recognizing coexisting pathology.

This article appears in HSS Journal: Volume 5, Number 2.
View the full article (pdf) at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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