Shoulder internal rotation elbow flexion test for diagnosing cubital tunnel syndrome

Kensuke Ochi, Yukio Horiuchi, Aya Tanabe, Makoto Waseda, Yasuhito Kaneko, Takahiro Koyanagi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Shoulder internal rotation enhances symptom provocation attributed to cubital tunnel syndrome. We present a modified elbow flexion test-the shoulder internal rotation elbow flexion test-for diagnosing cubital tunnel syndrome. Methods: Fifty-five ulnar nerves in cubital tunnel syndrome patients and 123 ulnar nerves in controls were examined with 5 seconds each of elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests before and after treatment (surgery in 18; conservative in others). For the shoulder internal rotation elbow flexion test position, 90° abduction, maximum internal rotation, and 10° flexion of the shoulder were combined with the elbow flexion test position. The test was considered positive if any symptom for cubital tunnel syndrome developed <5 seconds. Influence of the shoulder internal rotation elbow flexion test was evaluated by nerve conduction studies in 10 cubital tunnel syndrome nerves and 7 control nerves. Results: The sensitivities/specificities of the 5-second elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests were 25%/100%, 58%/100%, and 87%/98%, respectively. Sensitivity differences between the shoulder internal rotation elbow flexion test and the other two tests were significant. Shoulder internal rotation elbow flexion test results and cubital tunnel syndrome symptoms were significantly correlated. Influence of the shoulder internal rotation elbow flexion test on the ulnar nerve was seen in 8 of 10 cubital tunnel syndrome nerves but not in controls. Conclusions: The 5-second shoulder internal rotation elbow flexion test is specific, easy and quick provocative test for diagnosing cubital tunnel syndrome.

Original languageEnglish
Pages (from-to)777-781
Number of pages5
JournalJournal of Shoulder and Elbow Surgery
Volume21
Issue number6
DOIs
Publication statusPublished - 2012 Jun 1

Keywords

  • Compression
  • Cubital tunnel syndrome
  • Diagnostic Study
  • Elbow flexion
  • Level III
  • Shoulder internal rotation
  • Strain
  • Traction
  • Ulnar nerve palsy
  • Ulnar neuropathy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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