Cubital Tunnel Syndrome Test

What is a Cubital Tunnel Syndrome?

, also known as the Ulnar Nerve Entrapment at the elbow, is a condition where the ulnar nerve is compressed or entrapped, resulting in distressing symptoms for the patient. Right after carpal tunnel syndrome, it is the second most common compression neuropathy in the upper extremity. If left untreated, it can lead to the patient losing the function of the affected hand or arm.

To identify if the patient’s exhibited symptoms are due to the entrapment of the ulnar nerve, patients must conduct physical examinations such as the elbow flexion test, ask for the patient’s medical history, and have them undergo further tests like nerve conduction tests, X-Ray, and EMG.

Currently, there’s no standardized template for the elbow flexion test. So, for your benefit and convenience, we’ve created an elbow flexion test template you can use as a guide, reference, and document to write down your patient’s results.

Check out this video to see how the test is performed:

How does it work?

Step One. Access the Template

To access and download the template, do either of the following:

• Click the “Download Template or “Use this Template” button above
• Search for the “Cubital Tunnel Syndrome Test” or “Elbow Flexion Test” in Carepatron’s template library on the web or our app.

Step Two. Conduct the Test

Fill out the required basic information, such as the examination date, the patient’s name, and your name. Afterward, follow the test instructions provided in our template or below. \

Here are the instructions to conduct the elbow flexion test for cubital tunnel syndrome:

1. Have your patient in a standing or sitting position.
2. Ask your patient to flex their elbows maximally and supinate their forearms.
3. Afterward, ask your patient to extend the wrist fully.
4. Have the patient hold the position for 3-5 minutes.

Step Three. Interpret the Results

Move on with recording the patient’s results and any additional findings. Generally, patients test positive if they feel a tingling or numbness along the ulnar nerve root.

Step Four. Do Further Testing

If they test positive, we recommend that you do further tests to confirm a diagnosis. On the other hand, if they test negative, it’s ideal that you conduct other tests to formulate a clinical impression, at the very least.

Scoring Guide

Obtaining a Cubital Tunnel Syndrome Score is as easy as ticking the negative or positive checkbox based on their reaction and its corresponding interpretation. 

When would you use this test? 

Practitioners should conduct a cubital tunnel syndrome assessment when the patient exhibits symptoms of the syndrome, especially if they are risk factors for developing the disorder. 

To help you out, we listed the symptoms and risk factors of patients who may have cubital tunnel syndrome. 

Symptoms:

• Aching pain located on the inside of the elbow or the hand
• Numbness and tingling at night or on the hand, ring, and little finger, especially when the elbow is bent
• Weak grip and clumsiness because of muscle weakness on the affected arm and hand
• Compromised fine motor movements of the hand and fingers

Risk Factors:

• Patients who are over the age of 40
• Patients who are obese
• Those who do lean on their elbow or repetitive actions wherein their elbow is flexed for long periods at work (e.g., holding a phone/tool,  resting elbows on a hard surface like a desk, driving) 
• Those who participate in activities with repetitive overhead throwing, like athletes
• Those who have a prior elbow fracture or dislocation
• Those whose elbow joint has cysts or is swelling due to fluid buildup
• Those who have elbow arthritis or bone spurs
• Those who had a direct blow to the inside of the elbow

Do note that the symptoms of this disorder are similar to the other disorders or conditioners. Therefore, you must do further tests before diagnosing.

Benefits

Easy to Understand, Quick to Administer

With only a few instructions and no special equipment needed to conduct the test, you can easily understand, immediately administer the test, and obtain results in minutes.

Written Copies for Reference

As previously discussed, a standardized template does not exist. Therefore, our template can be utilized as a written point of reference to avoid overlooking results and to provide patients with a documented medical record of this test.

Fully Digital

Our free cubital tunnel syndrome test template is fully digital, enabling you to complete it using a local PDF editor or make modifications directly on Carepatron. Even better, if you edit this template on Carepatron, you can keep it and feel assured that you’re saving it on a HIPAA-compliant, secure EHR.

Accessible

Not only can you access our template on any gadget you have on hand, but fellow practitioners caring for the same patient can be given viewing access by you.

Research & Evidence

As indicated by several studies, the elbow flexion test is a reliable diagnostic tool for cubital tunnel syndrome. 

Buehler and Thayer (1988) conducted a test and concluded that the elbow flexion test is a "useful, reliable, and provocative test" for diagnosing cubital tunnel syndrome. Similarly, research by Novak, Mackinnon, and Lay (1994) demonstrated that combining elbow flexion with pressure on the ulnar nerve is the most sensitive test for diagnosing the condition. 

Another study by Rosati, Spagnolli, Nesti, and Lisanti (1998) found that performing the one-minute test can aid in diagnosing ulnar nerve compression at the cubital tunnel.

However, despite the potential usefulness of the elbow flexion test, practitioners are advised to conduct further testing on patients before arriving at a conclusive diagnosis. While these studies support the efficacy of the test, it is important to consider individual patient characteristics and perform additional examinations to ensure an accurate assessment of cubital tunnel syndrome.

References

Buehler, M. J., & Thayer, D. T. (1988). The elbow flexion test. A clinical test for the cubital tunnel syndrome. Clinical orthopaedics and related research, (233), 213–216.

Novak, C. B., Lee, G. W., Mackinnon, S. E., & Lay, L. (1994). Provocative testing for cubital tunnel syndrome. The Journal of hand surgery, 19(5), 817–820. https://doi.org/10.1016/0363-5023(94)90193-7‍

Rosati, M., Martignoni, R., Spagnolli, G., Nesti, C., & Lisanti, M. (1998). Clinical validity of the elbow flexion test for the diagnosis of ulnar nerve compression at the cubital tunnel. Acta orthopaedica Belgica, 64(4), 366–370.