Cubital tunnel syndrome (CuTS) is a common compression neuropathy of the ulnar nerve at the elbow. The gener- al anatomy and pathophysiology are well-documented, limited data exist regarding the anatomical dimensions of the cubital tunnel and relationship to nerve stability. This study aims to investigate ulnar nerve compression using ultrasound imaging and shear wave elastography (SWE). A cohort of healthy adult participants (18–60 years) will undergo ultrasound imaging of the cubital tunnel and flexor carpi ulnaris (FCU) at 30° and 90° elbow flexion under relaxed and stressed conditions. Measurements include ulnar nerve cross-sectional diameter, cubital tunnel dimen- sions on B-mode image and shear wave velocity (SWV, m/s) representing nerve stiffness and FCU muscle in SWE. Data is analyzed using a two-tailed paired t-test to examine the difference in SWV measured between 30° and 90° elbow flexion, and between joint relaxed and stressed conditions. We predict that ulnar nerve cross-sectional area and diameter will be largest under relaxed conditions at 30° flexion, correlating with reduced nerve stress measured via SWV. In contrast, at 90° flexion with stress applied to the FCU, nerve diameter decreases, and SWV values in- crease, suggesting greater compression. The study sample size was considered for data limitations. Studies suggest occupational and lifestyle factors likely contribute to CuTS risk. Understanding cubital tunnel biomechanics may improve diagnostic protocols and guide preventative measures. These imaging techniques could aid in screening for CuTS and inform lifestyle modifications to reduce nerve compression and assist in intervention for patients. Inter-operator reproducibility and intra-operator repeatability in performing SWE are tested using interclass cor- relation coefficient.
