Compressive ulnar neuropathy in the proximal forearm caused by a gouty tophus
✍ Scribed by Han-Cheng Wang; Ming-Dar Tsai
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 256 KB
- Volume
- 19
- Category
- Article
- ISSN
- 0148-639X
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✦ Synopsis
Ulnar neuropathy at the elbow constitutes a heterogenous group of conditions with varying cause^.^,^,^^ Entrapment neuropathy of the ulnar nerve associated with gouty tophus is rare.' We report such a case with the typical clinical presentation of cubital tunnel ~yndrome.',~ Although the case was indistinguishable from cubital tunnel syndrome clinically, it can be differentiated from true cases by electrodiagnostic findings. We report the case for its rarity and also to emphasize the importance of applying "inching technique" for precise localization in the diagnosis of ulnar neuropathy at the elbow.
CLINICAL HISTORY
The patient was a 51-year-old man with a chief complaint of aching pain involving the right medial elbow for 5 weeks, which extended to the forearm and the ulnar aspect of the right hand over the past 2 weeks.
Besides, he had noted progressive numbness in the small and ring fingers of the right hand and also weakness of the right hand over the past 8 weeks. The patient had a past history of attacks of gouty arthritis in bilateral first metatarsal joints for 4 years. Irregular treatment was sought for that problem. He denied any previous injuries to either elbow.
EXAMINATION
Tophaceous depositions were noted on the medial aspects of bilateral first metatarsal joints. There was no joint deformity at the elbow. Palpation at and around the elbow revealed no enlargement of the ulnar nerve and no mass. Tinel's sign could not be