Sonographic normal values for the cross-sectional area of the ulnar nerve: a systematic review and meta-analysis
Purpose Nerve size is a commonly used sonographic parameter when assessing suspected entrapment of the ulnar nerve. We aimed to create a robust set of normal values, based on a critical review of published normal values. Methods We performed a systematic evaluation of studies on normal ulnar nerve s...
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| Veröffentlicht in: | Journal of ultrasound 2023-03, Vol.26 (1), p.81-88 |
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| container_title | Journal of ultrasound |
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| creator | Boers, Nadine Martin, Enrico Mazur, Marc Krijgh, David D. Vlak, Monique H. M. de Ruiter, Godard C. W. Goedee, H. Stephan Coert, J. Henk |
| description | Purpose
Nerve size is a commonly used sonographic parameter when assessing suspected entrapment of the ulnar nerve. We aimed to create a robust set of normal values, based on a critical review of published normal values.
Methods
We performed a systematic evaluation of studies on normal ulnar nerve sizes, identified in PubMed, Embase, and Cochrane databases. Using meta-analyses, we determined pooled mean cross-sectional area (CSA) values for different anatomical locations of the ulnar nerve throughout the arm. Subgroup analyses were performed for gender, probe frequency, in- or exclusion of diabetic patients, position of the elbow and Asian versus other populations.
Results
We identified 90 studies of which 77 studies were included for further analyses after quality review, resulting in data from 5772 arms of 3472 participants. Subgroup analyses show lower CSA values at at the wrist crease and proximal to the wrist crease when using low frequency probes ( |
| doi_str_mv | 10.1007/s40477-022-00661-8 |
| format | Article |
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Nerve size is a commonly used sonographic parameter when assessing suspected entrapment of the ulnar nerve. We aimed to create a robust set of normal values, based on a critical review of published normal values.
Methods
We performed a systematic evaluation of studies on normal ulnar nerve sizes, identified in PubMed, Embase, and Cochrane databases. Using meta-analyses, we determined pooled mean cross-sectional area (CSA) values for different anatomical locations of the ulnar nerve throughout the arm. Subgroup analyses were performed for gender, probe frequency, in- or exclusion of diabetic patients, position of the elbow and Asian versus other populations.
Results
We identified 90 studies of which 77 studies were included for further analyses after quality review, resulting in data from 5772 arms of 3472 participants. Subgroup analyses show lower CSA values at at the wrist crease and proximal to the wrist crease when using low frequency probes (< 15 MHz) and at the wrist crease, proximal to the wrist crease, proximal forearm and the distal upper arm in Asians. CSA values were lower when in flexed position compared to extended position for the cubital tunnel inlet only. No difference was found for gender.
Conclusions
Our systematic review provides a comprehensive set of normal values at sites along the entire length of the ulnar nerve. This provides a foundation for clinical practise and upon which future studies could be more systematically compared.</description><identifier>ISSN: 1876-7931</identifier><identifier>ISSN: 1971-3495</identifier><identifier>EISSN: 1876-7931</identifier><identifier>DOI: 10.1007/s40477-022-00661-8</identifier><identifier>PMID: 35182316</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Elbow (anatomy) ; Entrapment ; Medicine ; Medicine & Public Health ; Meta-analysis ; Nerves ; Original Paper ; Subgroups ; Systematic review ; Ultrasound ; Wrist</subject><ispartof>Journal of ultrasound, 2023-03, Vol.26 (1), p.81-88</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-83f086917954e2804228c0940fa048f50f5d11216c8014badd5a28c7b62626ea3</cites><orcidid>0000-0002-0873-6405</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063700/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063700/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35182316$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boers, Nadine</creatorcontrib><creatorcontrib>Martin, Enrico</creatorcontrib><creatorcontrib>Mazur, Marc</creatorcontrib><creatorcontrib>Krijgh, David D.</creatorcontrib><creatorcontrib>Vlak, Monique H. M.</creatorcontrib><creatorcontrib>de Ruiter, Godard C. W.</creatorcontrib><creatorcontrib>Goedee, H. Stephan</creatorcontrib><creatorcontrib>Coert, J. Henk</creatorcontrib><title>Sonographic normal values for the cross-sectional area of the ulnar nerve: a systematic review and meta-analysis</title><title>Journal of ultrasound</title><addtitle>J Ultrasound</addtitle><addtitle>J Ultrasound</addtitle><description>Purpose
Nerve size is a commonly used sonographic parameter when assessing suspected entrapment of the ulnar nerve. We aimed to create a robust set of normal values, based on a critical review of published normal values.
Methods
We performed a systematic evaluation of studies on normal ulnar nerve sizes, identified in PubMed, Embase, and Cochrane databases. Using meta-analyses, we determined pooled mean cross-sectional area (CSA) values for different anatomical locations of the ulnar nerve throughout the arm. Subgroup analyses were performed for gender, probe frequency, in- or exclusion of diabetic patients, position of the elbow and Asian versus other populations.
Results
We identified 90 studies of which 77 studies were included for further analyses after quality review, resulting in data from 5772 arms of 3472 participants. Subgroup analyses show lower CSA values at at the wrist crease and proximal to the wrist crease when using low frequency probes (< 15 MHz) and at the wrist crease, proximal to the wrist crease, proximal forearm and the distal upper arm in Asians. CSA values were lower when in flexed position compared to extended position for the cubital tunnel inlet only. No difference was found for gender.
Conclusions
Our systematic review provides a comprehensive set of normal values at sites along the entire length of the ulnar nerve. This provides a foundation for clinical practise and upon which future studies could be more systematically compared.</description><subject>Elbow (anatomy)</subject><subject>Entrapment</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Nerves</subject><subject>Original Paper</subject><subject>Subgroups</subject><subject>Systematic review</subject><subject>Ultrasound</subject><subject>Wrist</subject><issn>1876-7931</issn><issn>1971-3495</issn><issn>1876-7931</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9UU1v1DAQtRCIloU_wAFZ4sLFMLYT2-GCqoovqRIH4GzNJpPdVIm92Mmi_fe4u6UUDsgHW3of43mPsecSXksA-yZXUFkrQCkBYIwU7gE7l84aYRstH957n7EnOV8D1I228jE707V0SktzznZfY4ibhLvt0PIQ04Qj3-O4UOZ9THzeEm9TzFlkauchhgJjIuSxP2LLGDDxQGlPbznyfMgzTTgXr0T7gX5yDB2faEaBRXrIQ37KHvU4Znp2e6_Y9w_vv11-EldfPn6-vLgSbaXMLJzuwZlG2qauSDmolHItNBX0CJXra-jrTkolTetAVmvsuhoLw66NKodQr9i7k-9uWU_UtRTmhKPfpWHCdPARB_83Eoat38S9L9EabQGKw6tbhxR_lEBmPw25pXHEQHHJXhkNjYKbJFfs5T_U67iksnFh2UY1tXW6KSx1Yh0TTdTf_UbCzVjrT4360qg_NupdEb24v8ed5HeFhaBPhFygsKH0Z_Z_bH8BMgGsoA</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Boers, Nadine</creator><creator>Martin, Enrico</creator><creator>Mazur, Marc</creator><creator>Krijgh, David D.</creator><creator>Vlak, Monique H. M.</creator><creator>de Ruiter, Godard C. W.</creator><creator>Goedee, H. Stephan</creator><creator>Coert, J. Henk</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0873-6405</orcidid></search><sort><creationdate>20230301</creationdate><title>Sonographic normal values for the cross-sectional area of the ulnar nerve: a systematic review and meta-analysis</title><author>Boers, Nadine ; Martin, Enrico ; Mazur, Marc ; Krijgh, David D. ; Vlak, Monique H. M. ; de Ruiter, Godard C. W. ; Goedee, H. Stephan ; Coert, J. Henk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-83f086917954e2804228c0940fa048f50f5d11216c8014badd5a28c7b62626ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Elbow (anatomy)</topic><topic>Entrapment</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Nerves</topic><topic>Original Paper</topic><topic>Subgroups</topic><topic>Systematic review</topic><topic>Ultrasound</topic><topic>Wrist</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boers, Nadine</creatorcontrib><creatorcontrib>Martin, Enrico</creatorcontrib><creatorcontrib>Mazur, Marc</creatorcontrib><creatorcontrib>Krijgh, David D.</creatorcontrib><creatorcontrib>Vlak, Monique H. M.</creatorcontrib><creatorcontrib>de Ruiter, Godard C. W.</creatorcontrib><creatorcontrib>Goedee, H. Stephan</creatorcontrib><creatorcontrib>Coert, J. Henk</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of ultrasound</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boers, Nadine</au><au>Martin, Enrico</au><au>Mazur, Marc</au><au>Krijgh, David D.</au><au>Vlak, Monique H. M.</au><au>de Ruiter, Godard C. W.</au><au>Goedee, H. Stephan</au><au>Coert, J. Henk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sonographic normal values for the cross-sectional area of the ulnar nerve: a systematic review and meta-analysis</atitle><jtitle>Journal of ultrasound</jtitle><stitle>J Ultrasound</stitle><addtitle>J Ultrasound</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>26</volume><issue>1</issue><spage>81</spage><epage>88</epage><pages>81-88</pages><issn>1876-7931</issn><issn>1971-3495</issn><eissn>1876-7931</eissn><abstract>Purpose
Nerve size is a commonly used sonographic parameter when assessing suspected entrapment of the ulnar nerve. We aimed to create a robust set of normal values, based on a critical review of published normal values.
Methods
We performed a systematic evaluation of studies on normal ulnar nerve sizes, identified in PubMed, Embase, and Cochrane databases. Using meta-analyses, we determined pooled mean cross-sectional area (CSA) values for different anatomical locations of the ulnar nerve throughout the arm. Subgroup analyses were performed for gender, probe frequency, in- or exclusion of diabetic patients, position of the elbow and Asian versus other populations.
Results
We identified 90 studies of which 77 studies were included for further analyses after quality review, resulting in data from 5772 arms of 3472 participants. Subgroup analyses show lower CSA values at at the wrist crease and proximal to the wrist crease when using low frequency probes (< 15 MHz) and at the wrist crease, proximal to the wrist crease, proximal forearm and the distal upper arm in Asians. CSA values were lower when in flexed position compared to extended position for the cubital tunnel inlet only. No difference was found for gender.
Conclusions
Our systematic review provides a comprehensive set of normal values at sites along the entire length of the ulnar nerve. This provides a foundation for clinical practise and upon which future studies could be more systematically compared.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>35182316</pmid><doi>10.1007/s40477-022-00661-8</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0873-6405</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of ultrasound, 2023-03, Vol.26 (1), p.81-88 |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Elbow (anatomy) Entrapment Medicine Medicine & Public Health Meta-analysis Nerves Original Paper Subgroups Systematic review Ultrasound Wrist |
| title | Sonographic normal values for the cross-sectional area of the ulnar nerve: a systematic review and meta-analysis |
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