Injection with corticosteroids (ultrasound guided) in patients with an ulnar neuropathy at the elbow, feasibility study
Article first published online: 16 FEB 2012
© 2012 The Author(s) European Journal of Neurology © 2012 EFNS
European Journal of Neurology
Volume 19, Issue 12, pages 1582–1584, December 2012
How to Cite
Alblas, C. L., van Kasteel, V. and Jellema, K. (2012), Injection with corticosteroids (ultrasound guided) in patients with an ulnar neuropathy at the elbow, feasibility study. European Journal of Neurology, 19: 1582–1584. doi: 10.1111/j.1468-1331.2012.03676.x
- Issue published online: 17 NOV 2012
- Article first published online: 16 FEB 2012
- Received 6 July 2011 Accepted 3 January 2012
- ulnar neuropathy
Introduction and purpose: Unlike carpal tunnel syndrome, little is known about injection with corticosteroids in patients with an ulnar neuropathy at the elbow (UNE). The purpose of this feasibility study is to see whether injection with corticosteroids is safe in patients with UNE and whether there are grounds to launch a prospective placebo-controlled study on the effects of corticosteroids.
Methods: Patients with clinical symptoms of UNE and a nerve conduction study compatible with UNE or thickened ulnar nerve at the elbow (> 10 mm2) by ultrasonography were included. All included patients received an ultrasound-guided injection of 1 ml containing 40 mg methylprednisoloneacetate and 10 mg lidocainhydrochloride (Depo-Medrol®). Complications of the injection were monitored. After 3 months, nerve conduction studies and ultrasonography were repeated and a clinical outcome determined.
Results: Eight patients with nine UNE were included. None of the patients mentioned increase in the symptoms directly after the injection nor had an infection on the injection site or haematoma. After 3 months, there was improvement of the symptoms in five patients. One patient deteriorated and three had no change of the symptoms at all. Overall, there was no significant change of the thickness of the ulnar nerve with mean difference −0.056 mm2 (95% CI −2.56 to 2.45 mm2).
Conclusion: We showed that injection with corticosteroids in patients with UNE is easy and safe, and based on this result, we found enough arguments to launch a prospective, placebo-controlled trial to explore the effectiveness of corticosteroids in patients with UNE.