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Ulnar Neuropathy At Guyon’s Canal Due To A Mass
 

Author: Kory Ford, MD
Affiliation: University of Utah Department of Physical Medicine & Rehabilitation
Co Author(s): Dan Cushman, MD
Senior Editor: Drew Duerson, MD

Clinical Vignette: A 51-year-old right-hand-dominant female presented with a 3-week history of insidious-onset throbbing, aching pain radiating from the right elbow to the hand, with associated hand weakness and a catching sensation in the wrist. She reported distal tingling when the catching occurred. Physical examination was notable for a positive Wartenberg sign, with the fourth and fifth digits abducted at rest, and 1/5 strength with finger adduction and abduction. Sensation was diminished in the ulnar distribution distal to the wrist. She was otherwise neurovascularly intact.

Type of Probe Used: 15-4 MHz Linear Array Transducer



Unlabeled short-axis view of the ulnar aspect of the volar wrist at the level of the pisiform.


Labeled short-axis view of the ulnar aspect of the volar wrist at the level of the pisiform (P), demonstrating a large mass (star) abutting the ulnar nerve (N) and ulnar artery (A).


Unlabeled long-axis view of the ulnar-sided volar wrist mass.


Labeled long-axis view of the ulnar-sided volar wrist demonstrating a large mass (star) overlying the flexor carpi ulnaris (FCU) tendon. 


Unlabeled long-axis view of the ulnar nerve at the volar wrist


Labeled long-axis view of the ulnar nerve at the volar wrist demonstrating a large mass (star) compressing the ulnar nerve (N).


Unlabeled comparison short-axis view of the ulnar-sided volar wrist at the level of the pisiform.


Labeled comparison short-axis view of the ulnar-sided volar wrist at the level of the pisiform (P). The unaffected left wrist demonstrates normal anatomy, whereas the affected right wrist demonstrates a large mass (star) abutting the ulnar nerve (N) and ulnar artery (A).

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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