Abstract
The lateral antebrachial cutaneous nerve may be entrapped by the biceps tendon or the brachialis muscle. Clinically, patients complain of pain and paresthesias radiating from the elbow to the base of the thumb. Dull aching of the radial aspect of the forearm is also common. The pain of lateral antebrachial cutaneous nerve entrapment at the elbow may develop after an acute twisting injury to the elbow or direct trauma to the soft tissues overlying the lateral antebrachial cutaneous nerve; in other cases, the onset of pain is more insidious, without an obvious inciting factor. The pain is constant and becomes worse with use of the elbow. Patients with lateral antebrachial cutaneous nerve entrapment often note an increase in pain when using a computer keyboard or playing the piano. Lateral antebrachial cutaneous nerve compromise may also be seen after overuse of the elbow, especially following activities which involve forced extension and maximal pronation of the elbow including tennis and weightlifting. Rupture of the proximal long head of the biceps may displace the nerve laterally, producing a traction neuropathy. Rarely, injury to the nerve during venipuncture with resultant neuropathy can occur. Sleep disturbance is common.
Keywords
lateral antebrachial cutaneous nerve, elbow pain, forearm pain, entrapment neuropathy, sports injury, lateral antebrachial cutaneous nerve block, ultrasound guided nerve block, diagnostic ultrasonography, rupture long head of biceps
ICD-10 CODE G56.80
Keywords
lateral antebrachial cutaneous nerve, elbow pain, forearm pain, entrapment neuropathy, sports injury, lateral antebrachial cutaneous nerve block, ultrasound guided nerve block, diagnostic ultrasonography, rupture long head of biceps
ICD-10 CODE G56.80
The Clinical Syndrome
The lateral antebrachial cutaneous nerve may be entrapped by the biceps tendon or the brachialis muscle ( Fig. 46.1 ). Clinically, patients complain of pain and paresthesias radiating from the elbow to the base of the thumb. Dull aching of the radial aspect of the forearm is also common. The pain of lateral antebrachial cutaneous nerve entrapment at the elbow may develop after an acute twisting injury to the elbow or direct trauma to the soft tissues overlying the lateral antebrachial cutaneous nerve; in other cases, the onset of pain is more insidious, without an obvious inciting factor. The pain is constant and becomes worse with use of the elbow. Patients with lateral antebrachial cutaneous nerve entrapment often note an increase in pain when using a computer keyboard or playing the piano ( Fig. 46.2 ). Lateral antebrachial cutaneous nerve compromise may also be seen after overuse of the elbow, especially following activities which involve forced extension and maximal pronation of the elbow including tennis and weightlifting. Rupture of the proximal long head of the biceps may displace the nerve laterally, producing a traction neuropathy ( Fig. 46.3 ). Rarely, injury to the nerve during venipuncture with resultant neuropathy can occur. Sleep disturbance is common.
