Tinel Sign Elbow | Cubital Tunnel Syndrome Assessment

Cubital tunnel syndrome is a peripheral entrapment neuropathy of the ulnar nerve at the elbow. It’s the second most common entrapment neuropathy of the upper limb and is commonly seen after trauma resulting in a fracture or dislocation at the elbow, arthritis, or repetitive strain.

According to a well-designed study by Beekman et al. (2009), the Tinel’s sign had a sensitivity of 62% and specificity of 53%, and even paired with other tests for the condition did not yield acceptable diagnostic ability which is why the clinical value is weak.

To conduct the test the patient is in sitting position. Support the arm to be tested and then using a reflex hammer lightly tap on the ulnar nerve just proximal to the cubital tunnel four to six times.

The test is positive if the patient reports familiar symptoms along the ulnar nerve that includes pain, tingling, and numbness.

Other orthopedic tests to assess for cubital tunnel syndrome are:

• Scratch Collapse Test
• Elbow Flexion Test/Flexion-Compression Test
• Pressure Provocation Test
• Shoulder Internal Rotation Test

References

Beekman, R., Schreuder, A. H. C. M. L., Rozeman, C. A. M., & Koehler, P. J. (2009). The diagnostic value of provocative clinical tests in ulnar neuropathy at the elbow is marginal. Journal of Neurology, Neurosurgery & Psychiatry, 80(12), 1369-1374.