Lesión del nervio cubital secundario a terapia de ondas de choque extracorpóreas radiales identificada con ultrasonografía de alta resolución: Reporte de caso.

English Title

Ulnar nerve injury after radial extracorporeal shock wave therapy identified with high–resolution ultrasonography: Case Report.

Authors

Walter Insuasti-Abarca, Departamento de Medicina Interna, Centro de Especialidades Ortopédicas, Quito-EcuadorFollow
Paul Terán-Vela
Diana Martínez-Asnalema
Tania Platero-Portillo
Sebastián Ramos-Rosas
Sussan Lloclla-Delgado

Keywords

ulnar neuropathy, extracorporeal shockwave therapy, medial epicondylitis, ultrasonography, case report

English Keywords

Ulnar neuropathy; Extracorporeal shockwave therapy; Medial epicondylitis; Ultrasonography; Case report

Abstract

A 49-year old woman was evaluated for developing bilateral acute medial elbow pain, numbness, and tingling sensation in the fourth and fifth fingers after receiving radial extracorporeal shock wave therapy (rESWT) for bilateral medial epicondylitis. Neurologic examination revealed the presence of Tinel’s sign, paresthesia and impaired two-point discrimination testing over the ulnar side of the fourth and fifth fingers bilaterally. High-resolution ultrasonography demonstrated findings of nerve injury, such as hypoechogenicity and increased diameter of both ulnar nerves. After conservative treatment, the patient improved her condition demonstrating an apparently acute compressive nerve injury as a result of the therapy. ESWT is used as a promising alternative for the treatment of various musculoskeletal disorders; however, there is limited evidence regarding its side effects, in particular peripheral mononeuropathy. To the authors’ knowledge, this is the first report demonstrating structural damage of a nerve after rESWT with the use of high-resolution ultrasonography.

English Abstract

A 49-year old woman was evaluated for developing bilateral acute medial elbow pain, numbness, and tingling sensation in the fourth and fifth fingers after receiving radial extracorporeal shock wave therapy (rESWT) for bilateral medial epicondylitis. Neurologic examination revealed the presence of Tinel’s sign, paresthesia and impaired two-point discrimination testing over the ulnar side of the fourth and fifth fingers bilaterally. High-resolution ultrasonography demonstrated findings of nerve injury, such as hypoechogenicity and increased diameter of both ulnar nerves. After conservative treatment, the patient improved her condition demonstrating an apparently acute compressive nerve injury as a result of the therapy. ESWT is used as a promising alternative for the treatment of various musculoskeletal disorders; however, there is limited evidence regarding its side effects, in particular peripheral mononeuropathy. To the authors’ knowledge, this is the first report demonstrating structural damage of a nerve after rESWT with the use of high-resolution ultrasonography.

Recommended Citation

Insuasti-Abarca, Walter; Terán-Vela, Paul; Martínez-Asnalema, Diana; Platero-Portillo, Tania; Ramos-Rosas, Sebastián; and Lloclla-Delgado, Sussan (2020) "Lesión del nervio cubital secundario a terapia de ondas de choque extracorpóreas radiales identificada con ultrasonografía de alta resolución: Reporte de caso.," Revista de la Facultad de Medicina Humana: Vol. 20: Iss. 2, Article 26.
Available at: https://inicib.urp.edu.pe/rfmh/vol20/iss2/26