What is Anconeus Epitrochlearis?
Anconeus Epitrochlearis is one of the rare causes of pain experienced in the forearms and elbows along with weakness that can be quite disabling for the individual. Anconeus Epitrochlearis is a pathological condition which is caused by the entrapment and compression of ulnar nerve at the elbow by the anconeus muscle. Due to this compression and entrapment, the patient experiences severe pain in the elbows with associated paresthesias in the lateral forearm radiating to the wrist and ring and little fingers.
The symptoms experienced by the patient suffering from anconeus epitrochlearis will often hamper his or her ability to use the forearm or elbows to do normal activities of daily living as prolonged use of the affected hand increases the symptoms profoundly, especially flexion.
What Causes Anconeus Epitrochlearis?
The main cause of Anconeus Epitrochlearis is repetitive and prolonged use of the hands like in construction or people who work in the cooking industry who have to use their hands a lot. Baseball players especially pitchers are also at risk for getting Anconeus Epitrochlearis. If Anconeus Epitrochlearis is left untreated it may result in severe motor deficits and ultimately flexion contracture of the affected fingers.
What are the Symptoms of Anconeus Epitrochlearis?
The presenting features of Anconeus Epitrochlearis include tenderness to palpation over the ulnar nerve at the elbow. The patient suffering from anconeus epitrochlearis will also have a positive Tinel's sign at the elbow. The patient will also have weakness of the muscles of the forearm and hand. The patient will also have altered sensation as a result of Anconeus Epitrochlearis. In some cases, the patient may have claw hand appearance also.
How is Anconeus Epitrochlearis Diagnosed?
The classic method for identifying Anconeus Epitrochlearis is to conduct an EMG test, as it helps to confirm the presence of Anconeus Epitrochlearis from other condition with similar symptoms like Golfer's Elbow. The physician will also order radiographs of the affected forearm and elbow to check for any bony pathology causing the symptoms and compressing the ulnar nerve. The physician may also order blood testing in the form of CBC, uric acid level, ESR, and ANA testing. The physician will also order advanced radiological studies in the form of MRI or CT scan of the forearm and elbow to look at the internal structures and to actually pinpoint as to where and what is compressing the ulnar nerve and if the anconeus muscle is the culprit compressing the ulnar nerve then Anconeus Epitrochlearis is confirmed.
What is the Treatment for Anconeus Epitrochlearis?
In the initial stages of Anconeus Epitrochlearis, the focus basically is on pain relief and decreasing inflammation along with improving functional ability so that the patient is able to do more with the hands at home or at work. This is done by the use of nonsteroidal antiinflammatories like Tylenol or Advil and COX-2 inhibitors.
This along with physical therapy is the route to go for treatment of Anconeus Epitrochlearis.
A heating pad can also be used at the area of the elbow and forearm as it is very beneficial in calming down the muscles and relieving pain. It is important to note here that patients with Anconeus Epitrochlearis need to stay away from using the affected hand for a period of time till the symptoms calm down.
The second mode of treatment for Anconeus Epitrochlearis is administration of injection of the ulnar nerve at the elbow under local anesthetic to relieve pain and improve the ability to use the hand in an effective way.
If all these treatments for Anconeus Epitrochlearis are not effective and the symptoms continue to persist then surgical exploration is the route to go where the surgeon will explore the area of compression and decompress and free up the ulnar nerve that has been entrapped by the anconeus muscle for relief of symptoms from Anconeus Epitrochlearis.