Which sign is typical of ulnar nerve neuropathy at the elbow?

• A. Tinel's sign at the elbow
• B. Froment's sign
• C. Phalen sign
• D. Wartenberg sign

Answer: (A)

Ulnar nerve irritation at the elbow usually presents with paresthesias in the ring and little fingers due to cubital tunnel compression. A hallmark bedside test is Tinel's sign at the elbow: tapping over the medial elbow where the ulnar nerve runs can reproduce tingling in the ulnar distribution. This localizes the irritation to the elbow itself. Other signs reflect ulnar nerve problems elsewhere. Froment's sign tests weakness of the adductor pollicis in the hand and is seen with hand-level ulnar palsy. Phalen's sign points to median nerve compression at the wrist (carpal tunnel). Wartenberg sign involves inability to adduct the little finger from ulnar nerve palsy in the hand. So, tapping over the elbow provoking symptoms is most characteristic of ulnar neuropathy at the elbow.