Clinical Kit 18/1/2013 | Anconeus Epitrochlearis

Hi

We have just completed an Advanced Upper Quadrant Course in Perth and an interesting piece of information surfaced, that I felt was worth sharing with the wider clinical group. It is in relation to compression of the ulna nerve in the cubital tunnel.

One of the course attendees, Ray Jongs from Sydney, works exclusively in the upper limb trauma and rehab arena and pointed out that there is a muscle present as an anomaly in approximately 20% of the population, that can cause compression to the ulna nerve (in addition to the FCU). Its called anconeus epitrochlearis. I have attached a link to a good 20 page review paper that looks at a wide variety of such anomalies in the upper and lower limb.

Summary

A wide array of supernumerary and accessory musculature has been described in the anatomic, surgical, and radiology literature. In the vast majority of cases, accessory muscles are asymptomatic and represent incidental findings at surgery or imaging. In some cases, however, accessory muscles may produce clinical symptoms. These symptoms may be related to a palpable swelling or may be the result of mass effect on neurovascular structures, typically in fibro-osseous tunnels. In cases in which an obvious cause for such symptoms is not evident, recognition and careful evaluation of accessory muscles may aid in diagnosis and treatment.

This Link will enable you to download the .pdf reference

All the best,

Doug Cary FACP
Specialist Musculoskeletal Physiotherapist (awarded by Australian College of Physiotherapy, 2009)
PhD Candidate Curtin University
Clinical Director AAP Education

email: doug@aapeducation.com.au

ph/fx: 08 90715055

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