Sağlıklı Bireylerde Anconeus Epitrochlearis Kasının Ulnar Sinire Etkisinin Dirsek Manyetik Rezonans Görüntüleme ile Değerlendirilmesi
Yıl 2024,
, 223 - 226, 20.08.2024
Esra Çıvgın
,
Muhammed Said Beşler
Öz
Amaç: Kubital tünel sendromu olmayan hastalarda anconeus epitrochlearis kasının ulnar sinir alanı ve sinyal yoğunluğuna etkisini manyetik rezonans görüntüleme ile belirlemek.
Gereç ve Yöntemler: Ocak 2020 ile Aralık 2022 tarihleri arasında dirsek manyetik rezonans görüntüleme yapılan hastalar retrospektif olarak değerlendirildi. Anconeus epitrochlearis kası olan, klinik ve elektromiyografi ile kubital tünel sendromu olmadığı gösterilen, 20 hasta çalışmaya dahil edildi. Yaş, cinsiyet ve taraf eşleştirmeli, kemik, bağ ve tendon patolojisi olmayan 20 dirsek manyetik rezonans görüntülemesi ile kontrol grubu oluşturuldu. Anconeus epitrochlearis kas alanının en geniş olduğu aksiyal kesitte ulnar sinir alanı ve intensitesi, anconeus epitrochlearis kas alanı ölçüldü ve bulgular istatistiksel olarak kontrol grubu ile karşılaştırıldı.
Bulgular: Anconeus epitrochlearis kas grubundaki hastaların yaş ortalaması 42.1±14.1 yıl (20-68 yıl) idi. Anconeus epitrochlearis kası olan ve olmayan grup arasında ulnar sinir alanı açısından istatistiksel olarak anlamlı fark saptanmadı (Anconeus epitrochlearis grubu:10.3±3.4 mm2, kontrol:9.4±2.7 mm2 p=0.376). Anconeus epitrochlearis kas alanı ile ulnar sinir alanı arasında korelasyon yoktu (r=-0.026, p=0.912). Ulnar sinir sinyal intensitesinde, iki grup karşılaştırıldığında anlamlı fark saptanmadı (p=0.317).
Sonuç: Anconeus epitrochlearis kasının ulnar sinir alanı ve intensitesi üzerinde etkisi yoktur.
Kaynakça
- Sookur PA, Naraghi AM, Bleakney RR, Jalan R, Chan O, White LM. Accessory muscles: Anatomy, symptoms, and radiologic evaluation. Radiographics. 2008;28(2):481- 499.
- Nascimento SRR, Ruiz CR. A study on the prevalence of the anconeus epitrochlearis muscle by magnetic resonance imaging. Rev Bras Ortop. 2018;53(3):373-377.
- Gruber W. The anomalous course of the ulnar nerve in front of the medial epicondyle. Arch Anat Physiol Wissen Med. 1867;1867:560e4.
- Diogo R, Siomava N, Gitton Y. Development of human limb muscles based on whole-mount immunostaining and the links between ontogeny and evolution. Development. 2019;146(20):dev180349.
- Gonzalez MH, Lotfi P, Bendre A, Mandelbroyt Y, Lieska N. The ulnar nerve at the elbow and its local branching: An anatomic study. J Hand Surg Br. 2001;26(2):142-144.
- Boero S, Sénès FM, Catena N. Pediatric cubital tunnel syndrome by anconeus epitrochlearis: A case report. J Shoulder Elbow Surg. 2009;18(2):e21-23.
- Cammarata MJ, Hill JB, Sharma S. Ulnar nerve compression due to anconeus epitrochlearis: A case report and review of the literature. JBJS Case Connect. 2019;9(2):e0189.
- Uscetin I, Bingol D, Ozkaya O, Orman C, Akan M. Ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle: A case report and surgical approach. Turk Neurosurg. 2014;24(2):266-271.
- Tiong WH, Kelly J. Ulnar nerve entrapment by anconeus epitrochlearis ligament. Hand Surg. 2012;17(1):83-84.
- Wilson TJ, Tubbs RS, Yang LJ. The anconeus epitrochlearis muscle may protect against the development of cubital tunnel syndrome: A preliminary study. J Neurosurg. 2016;125(6):1533-1538.
- Kim N, Stehr R, Matloub HS, Sanger JR. Anconeus epitrochlearis muscle associated with cubital tunnel syndrome: A case series. Hand (N Y). 2019;14(4):477-482.
- O'Hara JJ, Stone JH. Ulnar nerve compression at the elbow caused by a prominent medial head of the triceps and an anconeus epitrochlearis muscle. J Hand Surg Br. 1996;21(1):133-135.
- Jeon IH, Fairbairn KJ, Neumann L, Wallace WA. MR imaging of edematous anconeus epitrochlearis: Another cause of medial elbow pain? Skeletal Radiol. 2005;34(2):103-107.
- Dekelver I, Van Glabbeek F, Dijs H, Stassijns G. Bilateral ulnar nerve entrapment by the M. anconeus epitrochlearis. A case report and literature review. Clin Rheumatol. 2012;31(7):1139-1142.
- Eng HY, Gunio DA, Benitez CL. Quantitative magnetic resonance imaging analysis of the cross-sectional areas of the anconeus epitrochlearis muscle, cubital tunnel, and ulnar nerve with the elbow in extension in patients with and without ulnar neuropathy. J Shoulder Elbow Surg. 2018;27(7):1306-1310.
- Kawahara Y, Yamaguchi T, Honda Y, Tomita Y, Uetani M. The ulnar nerve at elbow extension and flexion: Assessment of position and signal intensity on MR images. Radiology. 2016;280(2):483-492.
- Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects--normal anatomy, variants, and pitfalls. Radiology. 2009;252(1):148-156.
EVALUATION OF THE EFFECT OF THE ANCONEUS EPITROCHLEARIS MUSCLE ON THE ULNAR NERVE IN HEALTHY SUBJECTS WITH ELBOW MAGNETIC RESONANCE IMAGING
Yıl 2024,
, 223 - 226, 20.08.2024
Esra Çıvgın
,
Muhammed Said Beşler
Öz
Objective: To determine the effect of anconeus epitrochlearis muscle on the ulnar nerve area and signal intensity in patients without cubital tunnel syndrome by magnetic resonance imaging.
Material and Methods: The elbow magnetic resonance images between January 2020 and December 2022 were evaluated retrospectively. Twenty patients with anconeus epitrochlearis muscle who were clinically and electromyographically shown not to have cubital tunnel syndrome were included in the study. The control group consisted of 20 age, gender and side-matched elbow magnetic resonance images without bone, ligament, and tendon pathology. The ulnar nerve area and intensity, anconeus epitrochlearis muscle area were measured in the axial slice where the anconeus epitrochlearis muscle area was the largest and the findings were statistically compared with the control group.
Results: The mean age in the anconeus epitrochlearis muscle group was 42.1±14.1 years (20-68 years). No significant difference in ulnar nerve area between the groups with and without anconeus epitrochlearis muscle was observed (Anconeus epitrochlearis group:10.3±3.4 mm2, control:9.4±2.7 mm2 p=0.376). There was no correlation between the ulnar nerve area and the anconeus epitrochlearis muscle area (r=-0.026, p=0.912). No significant difference in ulnar nerve signal intensity between the two groups was noted (p=0.317).
Conclusion: The anconeus epitrochlearis muscle had not a significant effect on the ulnar nerve area and intensity.
Etik Beyan
The study protocol was approved by the Ankara Bilkent City Hospital Clinical Research Ethics Committee (Date: 9.27.2023, Number: E2-23-5043)
Destekleyen Kurum
No financial support was received from any institution or person.
Kaynakça
- Sookur PA, Naraghi AM, Bleakney RR, Jalan R, Chan O, White LM. Accessory muscles: Anatomy, symptoms, and radiologic evaluation. Radiographics. 2008;28(2):481- 499.
- Nascimento SRR, Ruiz CR. A study on the prevalence of the anconeus epitrochlearis muscle by magnetic resonance imaging. Rev Bras Ortop. 2018;53(3):373-377.
- Gruber W. The anomalous course of the ulnar nerve in front of the medial epicondyle. Arch Anat Physiol Wissen Med. 1867;1867:560e4.
- Diogo R, Siomava N, Gitton Y. Development of human limb muscles based on whole-mount immunostaining and the links between ontogeny and evolution. Development. 2019;146(20):dev180349.
- Gonzalez MH, Lotfi P, Bendre A, Mandelbroyt Y, Lieska N. The ulnar nerve at the elbow and its local branching: An anatomic study. J Hand Surg Br. 2001;26(2):142-144.
- Boero S, Sénès FM, Catena N. Pediatric cubital tunnel syndrome by anconeus epitrochlearis: A case report. J Shoulder Elbow Surg. 2009;18(2):e21-23.
- Cammarata MJ, Hill JB, Sharma S. Ulnar nerve compression due to anconeus epitrochlearis: A case report and review of the literature. JBJS Case Connect. 2019;9(2):e0189.
- Uscetin I, Bingol D, Ozkaya O, Orman C, Akan M. Ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle: A case report and surgical approach. Turk Neurosurg. 2014;24(2):266-271.
- Tiong WH, Kelly J. Ulnar nerve entrapment by anconeus epitrochlearis ligament. Hand Surg. 2012;17(1):83-84.
- Wilson TJ, Tubbs RS, Yang LJ. The anconeus epitrochlearis muscle may protect against the development of cubital tunnel syndrome: A preliminary study. J Neurosurg. 2016;125(6):1533-1538.
- Kim N, Stehr R, Matloub HS, Sanger JR. Anconeus epitrochlearis muscle associated with cubital tunnel syndrome: A case series. Hand (N Y). 2019;14(4):477-482.
- O'Hara JJ, Stone JH. Ulnar nerve compression at the elbow caused by a prominent medial head of the triceps and an anconeus epitrochlearis muscle. J Hand Surg Br. 1996;21(1):133-135.
- Jeon IH, Fairbairn KJ, Neumann L, Wallace WA. MR imaging of edematous anconeus epitrochlearis: Another cause of medial elbow pain? Skeletal Radiol. 2005;34(2):103-107.
- Dekelver I, Van Glabbeek F, Dijs H, Stassijns G. Bilateral ulnar nerve entrapment by the M. anconeus epitrochlearis. A case report and literature review. Clin Rheumatol. 2012;31(7):1139-1142.
- Eng HY, Gunio DA, Benitez CL. Quantitative magnetic resonance imaging analysis of the cross-sectional areas of the anconeus epitrochlearis muscle, cubital tunnel, and ulnar nerve with the elbow in extension in patients with and without ulnar neuropathy. J Shoulder Elbow Surg. 2018;27(7):1306-1310.
- Kawahara Y, Yamaguchi T, Honda Y, Tomita Y, Uetani M. The ulnar nerve at elbow extension and flexion: Assessment of position and signal intensity on MR images. Radiology. 2016;280(2):483-492.
- Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects--normal anatomy, variants, and pitfalls. Radiology. 2009;252(1):148-156.