The feasibility of using high-resolution ultrasonography to assess ulnar nerve in patients with diabetes mellitus


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Journal of Ultrasonography

Polish Ultrasound Society (Polskie Towarzystwo Ultrasonograficzne)

Subject: Medicine


ISSN: 2084-8404
eISSN: 2451-070X





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VOLUME 17 , ISSUE 70 (September 2017) > List of articles

The feasibility of using high-resolution ultrasonography to assess ulnar nerve in patients with diabetes mellitus

Jun Chen / Chun-Lei Wang / Shan Wu * / Shan He / Jun Ren

Keywords : high-resolution ultrasonography, ulnar nerve, diabetes mellitus, peripheral

Citation Information : Journal of Ultrasonography. Volume 17, Issue 70, Pages 160-166, DOI:

License : (CC BY 4.0)

Received Date : 01-April-2017 / Accepted: 20-July-2017 / Published Online: 29-September-2017

Open Access article funded by Affiliated Hospital of Guiyang Medical University. No.[2015]7407 , Natural Science Fund of the Science , Technology Agency of Guizhou Province



Objective: The aim of this study was to investigate the usefulness of high-resolution ultra­sonography for the diagnosis of polyneuropathy in diabetes mellitus patients by the exami­nation of the ulnar nerves. Method: We recruited 100 healthy age-matched volunteers (50 women and 50 men) with 200 arms without diabetes or cubital tunnel syndrome as the control group. We assessed the upper limbs of 100 diabetes mellitus patients (45 women and 55 men), 40 of whom had electrophysiologically confirmed diabetic peripheral neu­ropathy and 60 had no diabetic peripheral neuropathy in the upper limbs. Age, sex, height and weight were recorded and the cross-sectional area of the ulnar nerve was measured at every predetermined site. Results: The cross-sectional area of the ulnar nerve was measured at six sites (mid-humerus, inlet of the cubital tunnel, outlet of the cubital tunnel, upon the medial epicondyle, 6 cm upon the wrist crease and Guyon tunnel). The ulnar nerve in two measuring sites (mid-humerus, upon the medial epicondyle) in the control group showed a statistical difference between men and women (p < 0.05). There was no statistical difference in the cross-sectional area in the control group when dominant and non-dominant arms were compared. The cross-sectional area was larger in the diabetic peripheral neuropathy group in three sites (inlet of the cubital tunnel, outlet of the cubital tunnel, Guyon tunnel) compared with those in the control group. Conclusion: High-resolution ultrasonography may be helpful in the early diagnosis of peripheral neuropathy in diabetic patients.

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Kovac B, Kovac B, Marusić-Emedi S, Svalina S, Demarin V: Clinical and electrophysiological signs of diabetic polyneuropathy – effect of glycemia and duration of diabetes mellitus. Acta Clin Croat 2011; 50: 149–157.


Agirman M, Yagci I, Leblebicier MA, Ozturk D, Akyuz GD: Is ultra­sonography useful in the diagnosis of the polyneuropathy in diabetic patients? J Phys Ther Sci 2016; 28: 2620–2624.


Rosenberg CJ, Watson JC: Treatment of painful diabetic peripheral neuropathy. Prosthet Orthot Int 2015; 39: 17–28.


Afsal M, Chowdhury V, Prakash A, Singh S, Chowdhury N: Evaluation of peripheral nerve lesions with high-resolution ultrasonography and color Doppler. Neurol India 2016; 64: 1002–1009.


Norkus SA, Meyers MC. Ulnar neuropathy of the elbow. Sports Med 1994; 17: 189–199.


Zheng Y, Wang L, Krupka TM, Wang Z, Lu G, Zhang P et al.: The feasi­bility of using high frequency ultrasound to assess nerve ending neu­ropathy in patients with diabetic foot. Eur J Radiol 2013; 82: 512–517.


Thoirs K, Williams MA, Phillips M: Ultrasonographic measurements of the ulnar nerve at the elbow: role of confounders. J Ultrasound Med 2008; 27: 737–743.


Cartwright MS, Shin HW, Passmore LV, Walker FO: Ultrasonographic reference values for assessing the normal median nerve in adults. J Neuroimaging 2009; 19: 47–51.


Yoon JS, Hong SJ, Kim BJ, Kim SJ, Kim JM, Walker FO et al.: Ulnar nerve and cubital tunnel ultrasound in ulnar neuropathy at the elbow. Arch Phys Med Rehabil 2008; 89: 887–889.


Posner MA: Compressive neuropathies of the ulnar nerve at the elbow and wrist. Instr Course Lect 2000; 49: 305–317.


Wiesler ER, Chloros GD, Cartwright MS, Shin HW, Walker FO: Ul­trasound in the diagnosis of ulnar neuropathy at the cubital tunnel. J Hand Surg Am 2006; 31: 1088–1093.


Alshami AM, Cairns CW, Wylie BK, Souvlis T, Coppieters MW: Reliabi­lity and size of the measurement error when determining the cross-sec­tional area of the tibial nerve at the tarsal tunnel with ultrasonography. Ultrasound Med Biol 2009; 35: 1098–1102.


Chen J, Wu S, Ren J: Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang, China. Neural Regen Res 2011; 6: 1883–1887.


Cartwright MS, Chloros GD, Walker FO, Wiesler ER, Campbell WW: Dia­gnostic ultrasound for nerve transection. Muscle Nerve 2007; 35: 796–799.


Chen J, Wu S, Ren J: Ultrasonographic reference values for assessing normal radial nerve ultrasonography in the normal population. Neural Regen Res 2014; 9: 1844–1849.


Viera C, Gálvez C, Carrasco B, Santos C, Castellanos R: A study of peripheral neural conduction, motor and sensory, in diabetic patients treated with hyperbaric oxygenation. Rev Neurol 1999; 28: 868–872.


Feki I, Lefaucheur JP: Correlation between nerve conduction studies and clinical scores in diabetic neuropathy. Muscle Nerve 2001; 24: 555–558.


Baba M, Ozaki I: Electrophysiological changes in diabetic neuropathy: from subclinical alterations to disabling abnormalities. Arch Physiol Biochem 2001; 109: 234–240.


Karsidag S, Morali S, Sargin M, Salman S, Karsidag K, Us O: The electrophysiological findings of subclinical neuropathy in patients with recently diagnosed type 1 diabetes mellitus. Diabetes Res Clin Pract 2005; 67: 211–219.


Sytze Van Dam P, Cotter MA, Bravenboer B, Cameron NE: Pathogene­sis of diabetic neuropathy: focus on neurovascular mechanisms. Eur J Pharmacol 2013; 719: 180–186.


Cutts S: Cubital tunnel syndrome. Postgrad Med J 2007; 83: 28–31.


Liu MT, Lee JT, Wang CH, Li YC, Chou CH: Cubital tunnel syndrome caused by ulnar nerve schwannoma in a patient with diabetic sensori­motor polyneuropathy. Acta Neurol Taiwan 2016; 25: 60–64.


Rota E, Morelli N: Entrapment neuropathies in diabetes mellitus. World J Diabetes 2016; 7: 342–353.


Kowalska B: Assessment of the utility of ultrasonography with high­-frequency transducers in the diagnosis of entrapment neuropathies. J Ultrason 2014; 14: 371–392.