Injection with corticosteroids (ultrasound guided) in patients with an ulnar neuropathy at the elbow, feasibility study

摘要

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 (10mm2) by ultrasonography were included. All included patients received an ultrasound-guided injection of 1ml containing 40mg methylprednisoloneacetate and 10mg lidocainhydrochloride (Depo-Medrol?). Complications of the injection were monitored. After 3months, 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 3months, 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 -0.056mm2 (95% CI -2.56 to 2.45mm2). 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.