Bahram Nico, MD; Andrew J. Waclawik, MD
Introduction: The diagnosis of ulnar neuropathy at the wrist traditionally has depended primarily on clinical and electrodiagnostic findings. Magnetic resonance imaging (MRI) and ultrasound have emerged as very important diagnostic tools in diagnosis of focal neuropathies.
Case Presentation: We present clinical, electrodiagnostic, and MRI findings in 2 patients with ulnar neuropathies at the wrist caused by ganglion cysts.
Discussion: Ulnar neuropathies at the wrist are common, may present with different patterns of motor and sensory deficits, and can be misdiagnosed. Nerve conduction studies and needle electromyography are essential to assist with anatomical localization of possible lesions. The structural lesions may be well characterized by MRI.
Conclusions: We conclude that MRI is a very useful and important diagnostic tool that may help with diagnosis and therapeutic decisions in patients with ulnar nerve lesions at the wrist. It complements the neurological exam and electrodiagnostic studies. High resolution ultrasound may be an adequate alternative to the MRI.