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Tinel's Sign: Ulnar Nerve (Guyon's)

Test, Exam and Sign Description

Ulnar neuropathy at the wrist level is known to occur in a space referred to as Guyon's Canal. Guyon, in 1861, described a space adjacent to the hypothenar eminence that contains the ulnar nerve artery and vein. Guyon indicated the potential for nerve entrapment at this area.

Description

The ulnar nerve percussion test at the wirst is performed by percussion with a finger or relfex hammer over the ulnar nerve (Guyon's Canal) at the wrist.

Presentation Photos and Related Diagrams
  • Tinel's Sign at Guyon's canal.
    Tinel's Sign at Guyon's canal.
Definition of Positive Result
  • A positive test produces paresthesias in the ulnar nerve distribution (ulnar aspect of the ring finger, and little finger).
Definition of Negative Result
  • A negative test will not produce any parasthesias, numbness or tingling in the hand.
Comments and Pearls
  • Positive Tinel's sign at Guyon's canal usually secondary to mass in Guyon's canal like a ganglion or lipoma.
  • Location of lesion in the canal will affect either the motor, sensory or both components of the nerve.
Diagnoses Associated with Tests, Exams and Signs
CARPAL TUNNEL SYNDROME
CERVICAL RADICULOPATHY
GANGLION WRIST
CUBITAL TUNNEL SYNDROME
Video
Tinel's sign at Guyon's canal
References

1. Peimer, C. (1996). Compression Neuropathies: Ulnar. In Surgery of the hand and upper extremity (Vol. 2, pp. 1340, 1345-1346). New York, NY: McGraw-Hill, Health Professions Division.

2. Brown, D. (2004). Orthopedic secrets (Third ed., p. 205). Philadelphia, PA: Hanley and Belfus, an affiliate of Elsevier.

3. Hammert, W. (2010). Nerve. In ASSH manual of hand surgery (1st ed., pp. 318-319). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.