J Rheum Dis.  2012 Dec;19(6):348-350. 10.4078/jrd.2012.19.6.348.

Attritional Rupture of Ulnar Nerve in a Patient with Rheumatoid Arthritis

• Cho CH
• Kim BS
• Bae KC
• Chae JN
• Kim SH

• KMID: 2223062
• DOI: http://doi.org/10.4078/jrd.2012.19.6.348

Abstract

Ulnar neuropathy around the elbow in patients with rheumatoid arthritis can occur by synovial invasion, flexion contracture or valgus deformity of the elbow. However, attritional rupture of the ulnar nerve by medial osteophyte with synovial invasion of the rheumatoid elbow is extremely rare. We reported a case of attritional rupture of the ulnar nerve by medial osteophyte in 62 years-old male with rheumatoid arthritis. Exact diagnosis and proper treatment are required if symptoms of ulnar neuropathy present in rheumatoid arthritis with contracture and valgus deformity of the elbow.

Keyword

Rheumatoid arthritis; Ulnar nerve; Synovial invasion; Attritional rupture

MeSH Terms

Arthritis, Rheumatoid
Congenital Abnormalities
Contracture
Elbow
Humans
Male
Osteophyte
Rupture
Ulnar Nerve
Ulnar Neuropathies

Figure

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  Figure 1 Clinical photograph shows atrophy of adductor pollicis and dorsal interossei muscles with claw hand deformity in 62 year-old male with rheumatoid arthritis.

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  Figure 2 Plain radiographs show severe arthritic changes with medial osteophyte of trochlea (white arrow) and valgus deformity.

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  Figure 3 Intraoperative findings show attritional rupture (white arrow) of ulnar nerve by medial osteophyte (black arrow) (A, B). Ulnar nerve is transposed anteriorly and repaired by an end-to-end technique (C, D).

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