A case of ulnar neuritis with persistent elbow pain for nine years

Abstract

Ulnar nerve dysfunction causes pain and numbness in the ring and little fingers. We report a case of ulnar neuritis with only elbow pain. A 79-year-old man with left elbow pain for nine years was treated with a combination of pregabalin and tramadol/acetaminophen. He visited our department because his symptoms worsened with increased nocturnal awakenings due to pain. He complained of resting pain (numerical rating scale score: 8/10) at a point inside his left pulled elbow. No psychosocial problems, symptoms in his hand, or abnormal radiographic findings of the elbow were observed. A left ulnar nerve block was performed under ultrasound guidance as the tender point coincided with the left elbow canal; an improvement in the elbow pain indicated a dysfunction of the left ulnar nerve. Nerve conduction and sensory examinations of the ulnar nerve revealed no abnormalities; however, edema-like changes on magnetic resonance imaging indicated an ulnar neuritis. The symptoms improved with a nerve block and administration of duloxetine.