The prevalence of cubital tunnel syndrome: A cross-sectional study in a U.S. metropolitan cohort

Background: Although cubital tunnel syndrome is the second most common peripheral mononeuropathy (after carpal tunnel syndrome) encountered in clinical practice, its prevalence in the population is unknown. The objective of this study was to evaluate the prevalence of cubital tunnel syndrome in the general population. Methods: We surveyed a cohort of adult residents of the St. Louis metropolitan area to assess for the severity and localization of hand symptoms using the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and the Katz hand diagram. We identified subjects who met our case definitions for cubital tunnel syndrome and carpal tunnel syndrome: self-reported hand symptoms associated with a BCTQ-SSS score of >2 and localization of symptoms to the ulnar nerve or median nerve distributions. Results: Of 1,001 individuals who participated in the cross-sectional survey, 75% were women and 79% of the cohort was white; the mean age (and standard deviation) was 46 ± 15.7 years. Using a more sensitive case definition (lax criteria), we identified 59 subjects (5.9%) with cubital tunnel syndrome and 68 subjects (6.8%) with carpal tunnel syndrome. Using a more specific case definition (strict criteria), we identified 18 subjects (1.8%) with cubital tunnel syndrome and 27 subjects (2.7%) with carpal tunnel syndrome. Conclusions: The prevalence of cubital tunnel syndrome in the general population may be higher than that reported previously. When compared with previous estimates of disease burden, the active surveillance technique used in this study may account for the higher reported prevalence. This finding suggests that a proportion of symptomatic subjects may not self-identify and may not seek medical treatment. Clinical Relevance: This baseline estimate of prevalence for cubital tunnel syndrome provides a valuable reference for future diagnostic and prognostic study research and for the development of clinical practice guidelines.