PURPOSE: Cubital tunnel syndrome is a well-described entity with many reported etiologies and anatomical compression sites. Accessory ossicles of either traumatic or congenital origin might occur around the elbow joint. Only one case reporting such ossicles compressing the ulnar nerve exists in previous literature. We aim to present this entity with a detailed description of the patient history and treatment. CASE REPORT: We report a case of 30-year-old female presenting with classical signs of cubital tunnel syndrome-positive Wartenberg's and Froment's signs, hypoesthesia in the fourth and fifth finger with decreased finger duction strength but without gross hypotrophy of interosseous and hypothenar muscles. Tinel's sign was positive over the ulnar sulcus and an accessory ossicle was found on the elbow radiograph within the ulnar sulcus. The first signs of calcification in this patient were reported 6 years prior in a follow-up after the dislocation of her elbow joint following a bike accident. The EMG confirmed ulnar nerve neuropathy in the elbow area. The ossicle was extirpated, the ulnar nerve was decompressed in the ulnar sulcus in a standard manner and the symptoms quickly resolved. The patient has been regularly visiting our outpatient clinic for the next 12 years without any complaints considering her elbow and the ulnar nerve. CONCLUSION: This is a rare case of cubital tunnel syndrome caused by an accessory ossicle of traumatic origin. Simple bone extirpation with ulnar nerve release followed by anterior subcutaneous transposition is the recommended method of treatment. No report of congenital accessory bones causing ulnar nerve compression in the elbow exists in the literature.

• Keywords
• Accessory bones, Cubital tunnel syndrome, Pathologic ossification, Ulnar nerve neuropathy,
• MeSH
• Adult MeSH
• Ossification, Heterotopic * diagnosis   diagnostic imaging   MeSH
• Humans MeSH
• Elbow MeSH
• Elbow Joint * physiology   MeSH
• Ulnar Nerve MeSH
• Cubital Tunnel Syndrome * MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

• Keywords
• LIGAMENTS/diseases *, OSSIFICATION/in infancy and childhood *,
• MeSH
• Arthritis * MeSH
• Child MeSH
• Fascia * MeSH
• Ossification, Heterotopic * MeSH
• Infant MeSH
• Humans MeSH
• Ligaments * MeSH
• Patellar Ligament * MeSH
• Disease * MeSH
• Osteogenesis * MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Adult MeSH
• Ossification, Heterotopic diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Joint Diseases diagnostic imaging   pathology   MeSH
• Ochronosis pathology   MeSH
• Radiography MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• Keywords
• EPIPHYSES *, GROWTH *, HAND *, OSSIFICATION *, PUBERTY *,
• MeSH
• Epiphyses * MeSH
• Physiological Phenomena * MeSH
• Ossification, Heterotopic * MeSH
• Humans MeSH
• Osteogenesis * MeSH
• Sexual Maturation * MeSH
• Puberty * MeSH
• Hand * MeSH
• Growth * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

• Keywords
• OSSIFICATION *,
• MeSH
• Ossification, Heterotopic * MeSH
• Humans MeSH
• Osteogenesis * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Heterotopic ossification (HO) denotes aberrant osteogenesis in extra-skeletal tissues, often associated with neurological disorders, total hip arthroplasty, and specific traumatic scenarios. Neurogenic heterotopic ossification manifests prominently subsequent to traumatic brain injury or spinal cord injury, with Guillain-Barre Syndrome presenting an infrequent etiological link. This article details the case of a 56-year-old female diagnosed with Guillain-Barre Syndrome, who developed neurogenic heterotopic ossification around both hips within two years of disease onset. The patient's medical history included mechanical ventilation, incomplete tetraplegia, and prolonged immobilization. A conclusive diagnosis of HO was established through radiological and clinical assessments. After neurogenic heterotopic ossification was confirmed, the patient had surgery to remove the lesions, radiation therapy, and medication treatments as planned. Physical therapy was introduced one week post-surgery, with subsequent follow-ups tracking improvements in pain levels, range of motion (ROM), and Activities of Daily Living scores. Key words: neurogenic heterotopic ossification, Guillain-Barre syndrome, hip, excision.

• MeSH
• Guillain-Barre Syndrome complications   diagnosis   therapy   MeSH
• Ossification, Heterotopic * etiology   diagnosis   MeSH
• Hip Joint * diagnostic imaging   surgery   MeSH
• Middle Aged MeSH
• Humans MeSH
• Range of Motion, Articular MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

• MeSH
• Fluorides adverse effects   MeSH
• Ossification, Heterotopic chemically induced   diagnostic imaging   MeSH
• Humans MeSH
• Ligaments diagnostic imaging   drug effects   MeSH
• Radiography MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Fluorides MeSH

This case presents the utility of ultrasound examination in diagnostics, providing accurate therapy and follow-up of entrapment syndrome of the ulnar nerve, caused by heterotopic ossification. The heterotopic ossifications were in this case presumably linked to a long-term working with a vibration sander.

• MeSH
• Ossification, Heterotopic complications   MeSH
• Humans MeSH
• Aged MeSH
• Cubital Tunnel Syndrome diagnostic imaging   etiology   MeSH
• Ultrasonography MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Letter MeSH
• Case Reports MeSH

• Keywords
• OSSIFICATION *,
• MeSH
• Ossification, Heterotopic * MeSH
• Humans MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

• Keywords
• HYOID BONE *, OSSIFICATION *,
• MeSH
• Ossification, Heterotopic * MeSH
• Larynx * MeSH
• Humans MeSH
• Hyoid Bone * MeSH
• Osteogenesis * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH