Skip to main content
Have a personal or library account? Click to login
Ultrasound-guided therapeutic injection of the surgically transposed ulnar nerve at the elbow: sonographic appearances, technique and clinical follow-up Cover

Ultrasound-guided therapeutic injection of the surgically transposed ulnar nerve at the elbow: sonographic appearances, technique and clinical follow-up

Open Access
|Jun 2026

References

  1. Bartels RH, Menovsky T, Van Overbeeke JJ, Verhagen WI. Surgical management of ulnar nerve compression at the elbow: an analysis of the literature. J Neurosurg. 1998 Nov;89(5):722–727. doi: 10.3171/jns.1998.89.5.0722.
  2. Caliandro P, La Torre G, Padua R, Giannini F, Padua L. Treatment for ulnar neuropathy at the elbow. Cochrane Database Syst Rev. 2016 Nov 15;11(11):CD006839. doi: 10.1002/14651858.CD006839.pub4. Update in: Cochrane Database Syst Rev. 2025 Apr 29;4:CD006839. doi: 10.1002/14651858.CD006839.pub5.
  3. Mowlavi A, Andrews K, Lille S, Verhulst S, Zook EG, Milner S. The management of cubital tunnel syndrome: a meta-analysis of clinical studies. Plast Reconstr Surg. 2000 Aug;106(2):327–334. doi: 10.1097/00006534-200008000-00014.
  4. Nellans K, Tang P. Evaluation and treatment of failed ulnar nerve release at the elbow. Orthop Clin North Am. 2012;43:487–494. doi: 10.1016/j.ocl.2012.07.018.
  5. Chang KV, Wu WT, Han DS, Özçakar L. Ulnar nerve cross-sectional area for the diagnosis of cubital tunnel syndrome: a meta-analysis of ultrasonographic measurements. Arch Phys Med Rehabil. 2018 Apr;99(4):743–757. doi: 10.1016/j.apmr.2017.08.467.
  6. Tang P, Hoellwarth JS, Chauhan A. Recurrent cubital tunnel syndrome: a critical analysis review. JBJS Rev. 2016 Mar 8;4(3):e3. doi: 10.2106/JBJS.RVW.O.00022.
  7. Sivakumaran T, Sneag DB, Lin B, Endo Y. MRI of the ulnar nerve pre- and post-transposition: imaging features and rater agreement. Skeletal Radiol. 2021 Mar;50(3):559–570. doi: 10.1007/s00256-020-03598-3.
  8. Daniels SP, Mintz DN, Endo Y, Dines JS, Sneag DB. Imaging of the post-operative medial elbow in the overhead thrower: common and abnormal findings after ulnar collateral ligament reconstruction and ulnar nerve transposition. Skeletal Radiol. 2019 Dec;48(12):1843–1860. doi: 10.1007/s00256-019-03246-5.
  9. Kowalska B, Sudoł-Szopińska I. Ultrasound assessment of selected peripheral nerve pathologies. Part III: Injuries and postoperative evaluation. J Ultrason. 2013 Mar;13(52):82–92. doi: 10.15557/JoU.2013.0007.
  10. Gruber H, Baur EM, Plaikner M, Loizides A. The ulnar nerve after surgical transposition: can sonography define the reason of persisting neuropathy? Rofo. 2015 Nov;187(11):998–1002. doi: 10.1055/s-0035-1553221.
  11. Chen IJ, Chang KV, Wu WT, Özçakar L. Ultrasound parameters other than the direct measurement of ulnar nerve size for diagnosing cubital tunnel syndrome: a systemic review and meta-analysis. Arch Phys Med Rehabil. 2019 Jun;100(6):1114–1130. doi: 10.1016/j.apmr.2018.06.021.
  12. Walsh PJ, Walter WR, Burke CJ, Adler RS, Beltran LS. Percutaneous ultrasound-guided intervention for upper extremity neural and perineural abnormalities: a retrospective review of 242 cases. AJR Am J Roentgenol. 2019 Mar;212(3):W73–W82. doi: 10.2214/AJR.18.20047.
  13. Gronbeck C, Wolf J, Rodner CM. Ultrasound-guided cubital tunnel injection: a review and exploration of utility as a diagnostic aid in mild or nonclassic cubital tunnel patients. Techniques in Orthopaedics. 2021;36(3):301–306. doi: 10.1097/BTO.0000000000000450.
  14. Hamscha UM, Tinhofer I, Heber S, Grisold W, Weninger WJ, Meng S. A reliable technique for ultrasound-guided perineural injection in ulnar neuropathy at the elbow. Muscle Nerve. 2017 Aug;56(2):237–241. doi: 10.1002/mus.25490.
  15. Tranchitella NM, Pottanat PJ, Sherrier M. Ulnar nerve hydrodissection at the elbow with ultrasound guidance. Video Journal of Sports Medicine. 2024;4:1–4. doi: 10.1177/26350254241244405.
  16. vanVeen KE, Alblas KC, Alons IM, Kerklaan JP, Siegersma MC, Wesstein M, et al. Corticosteroid injection in patients with ulnar neuropathy at the elbow: A randomized, double-blind, placebo-controlled trial. Muscle Nerve. 2015 Sep;52(3):380–385. doi: 10.1002/mus.24551.
  17. Chang KV, Wu WT, Özçakar L. Ultrasound imaging and guidance in peripheral nerve entrapment: hydrodissection highlighted. Pain Manag. 2020 Mar;10(2):97–106. doi: 10.2217/pmt-2019-0056.
  18. Alblas CL, van Kasteel V, Jellema K. Injection with corticosteroids (ultrasound guided) in patients with an ulnar neuropathy at the elbow, feasibility study. Eur J Neurol. 2012 Dec;19(12):1582–1584. doi: 10.1111/j.1468-1331.2012.03676.x.
  19. Rampen AJ, Wirtz PW, Tavy DL. Ultrasound-guided steroid injection to treat mild ulnar neuropathy at the elbow. Muscle Nerve. 2011 Jul;44(1):128–130. doi: 10.1002/mus.22091.
  20. Choi CK, Lee HS, Kwon JY, Lee WJ. Clinical implications of real-time visualized ultrasound-guided injection for the treatment of ulnar neuropathy at the elbow: a pilot study. Ann Rehabil Med. 2015 Apr;39(2):176–182. doi: 10.5535/arm.2015.39.2.176.
  21. Hutchinson DT, Sullivan R, Sinclair MK. Long-term reoperation rate for cubital tunnel syndrome: subcutaneous transposition versus in situ decompression. Hand (N Y). 2021 Jul;16(4):447–452. doi: 10.1177/1558944719873153.
  22. Chhabra A, Deshmukh SD, Lutz AM, Fritz J, Andreisek G, Sneag DB, et al. Neuropathy Score Reporting and Data System: a reporting guideline for MRI of peripheral neuropathy with a multicenter validation study. AJR Am J Roentgenol. 2022 Aug;219(2):279–291. doi: 10.2214/AJR.22.27422.
  23. Abiri B, Kopylov D, Samim M, Walter W, Fritz J, Khodarahmi I, Burke CJ. MRI grading using the neuropathy score-reporting and data system with electrodiagnostic correlation in radial neuropathy around the elbow: a 13-year retrospective review. Skeletal Radiol. 2025 Aug;54(8):1621–1630. doi: 10.1007/s00256-024-04861-7.
  24. Chhabra A, Duarte Silva F, Mogharrabi B, Guirguis M, Ashikyan O, Rasper M, et al. MRI-based Neuropathy Score Reporting and Data System (NS-RADS): multi-institutional wider-experience usability study of peripheral neuropathy conditions among 32 radiology readers. Eur Radiol. 2024 Aug;34(8):5228–5238. doi: 10.1007/s00330-023-10517-2.
  25. Goyal A, Wadgera N, Srivastava DN, Ansari MT, Dawar R. Imaging of traumatic peripheral nerve injuries. J Clin Orthop Trauma. 2021 Jul 19;21:101510. doi: 10.1016/j.jcot.2021.101510.
  26. Wijntjes J, Borchert A, van Alfen N. Nerve ultrasound in traumatic and iatrogenic peripheral nerve injury. Diagnostics (Basel). 2020 Dec 26;11(1):30. doi: 10.3390/diagnostics11010030.
  27. MacMahon PJ, Eustace SJ, Kavanagh EC. Injectable corticosteroid and local anesthetic preparations: a review for radiologists. Radiology. 2009 Sep;252(3):647–661. doi: 10.1148/radiol.2523081929.
  28. Byun YS, Lee SU, Park IJ, Im JH, Hong SA. Comparison of in-situ release and submuscular anterior transposition of ulnar nerve for refractory cubital tunnel syndrome, previously treated with subfascial anterior transfer-A retrospective study of 24 cases. Injury. 2023 Dec;54(12):111061. doi: 10.1016/j.injury.2023.111061.
  29. Tay HW, Lee WQ, Puah KL, Lie DTT. The modified fascial sling technique for ulnar nerve anterior transposition: surgical techniques and results. JSES Rev Rep Tech. 2023 May 26;3(3):370–375. doi: 10.1016/j.xrrt.2023.04.006.
DOI: https://doi.org/10.15557/jou.2026.0011 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
Language: English
Submitted on: Jul 16, 2025
Accepted on: Mar 16, 2026
Published on: Jun 30, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Christopher John Burke, Vinh Tran, Allison Weinstock, Dhruv Shankar, Ronald Adler, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 26 (2026): Issue 105 (June 2026)