Execution
- 1Position the patient with the medial elbow exposed and relaxed.
- 2Identify the ulnar nerve groove between the olecranon and the medial epicondyle.
- 3Tap over the ulnar nerve in the groove.
- 4Ask whether tingling or paresthesia travels into the ulnar distribution.
- 5Map the most distal point of abnormal sensation if nerve regeneration is being followed.
Positive outcome
Tingling or paresthesia in the ulnar distribution of the forearm and hand distal to the tapping point is positive. Magee states that the most distal point where abnormal sensation is felt represents the limit of sensory nerve regeneration.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Novak et al. (1994) | NA | 70 | 98 | 35 | 0.31 |
CommentNovak’s values look strong, especially specificity, but cubital tunnel test performance varies across populations and reference standards. A positive Tinel sign localizes irritability at the cubital tunnel but does not grade severity by itself. Combine it with sensory testing, intrinsic strength, and electrodiagnostic or ultrasound findings when needed.
High Clinical Value