1/2. electrodiagnosis in entrapment neuropathy by the arcade of Struthers.Two cases of high ulnar nerve neuropathy are reported. Lesions were localized at the midarm level by electrophysiologic studies. In the first case, the lesion was found mainly to be a prolonged neurapraxia, and neurolysis was effective. The ulnar nerve was swollen 1 cm in length under the arcade of Struthers. After neurolysis, the palsy recovered rapidly. In the other case, the lesion seemed to be a mild injury to the myelin sheath. Delayed segmental conduction velocity and partial conduction block were found at the midarm level. The paresis improved slightly during the 11-month followup without any treatment, but the electrophysiologic studies were unchanged. In both cases, physical examination did not distinguish the lesions from cubital tunnel syndrome. Electrophysiologic examination proved to be effective as a diagnostic procedure. In the presence of ulnar neuropathy, the upper arm segment should be included in a routine nerve conduction study to screen for the rare but important entrapment neuropathy caused by the arcade of Struthers.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/2. Pseudomalignant myositis ossificans of the wrist causing compression of the ulnar nerve and artery. A case report.myositis ossificans (MO) is a condition characterised by focal, benign and self-limited idiopathic heterotopic bone formation. It is extremely rare in the hand and wrist and may lead to concomitant nerve compression. Because of the rare incidence of pseudomalignant MO at the wrist and hand, we found it of interest to report a case of this condition localised to the wrist. A 31-year-old female patient presented with swelling and pain of her left wrist. The physical examination findings, magnetic resonance imaging and Tc-99m bone scan suggested acute osteomyelitis or a tumoral condition. Incisional biopsy and pathological examination was done. The microscopic findings confirmed that the lesion was pseudomalignant MO. The lesion was removed totally and decompression of the ulnar nerve and artery was achieved. The patient regained full asymptomatic range of motion of all digits and wrist and the numbness of the fourth and fifth digits had subsided at follow-up five months later.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |