We appreciate the comments suggested by Rubin et al. regarding our article on the relationship between medial elbow pain and ulnar neuropathy at the elbow. We agree with their conclusion that the likelihood of diagnosing UNE is low in patients with medial elbow pain and “soft” findings, such as intermittent ulnar nerve parasthesias and a positive Tinel sign over the ulnar nerve at the elbow. We attempted to emphasize this point in the discussion of our results.
Medial elbow pain is described as a symptom of ulnar neuropathy at the elbow in standard texts. The elbow pain is likely musculoskeletal and related to the medial epicondyle or other structures. Medial elbow pain is less likely analogous to the proximal arm or shoulder pain reported by patients with median neuropathy at the wrist. Based on our findings, medial elbow pain does not appear to be associated with UNE diagnosed with electrodiagnostic examination. Referral for an electrodiagnostic study to assess medial elbow pain with vague signs or symptoms of UNE should be reconsidered.