A patient reports pain and swelling in the medial aspect of the elbow and tingling in the ring and little fingers with a positive elbow flexion test. The MOST likely condition is?

• A. C5 radiculopathy
• B. Medial epicondylalgia
• C. Cubital tunnel syndrome
• D. Olecranon bursitis

Answer: (C)

The elbow flexion test targets compression of the ulnar nerve at the elbow, in the cubital tunnel. When the elbow is bent, the space inside the cubital tunnel narrows and the pressure on the ulnar nerve increases. If the nerve is irritated or compressed, this position reproduces symptoms—specifically numbness or tingling in the ring and little fingers, which are supplied by the ulnar nerve, along with medial elbow pain.

Medial epicondylalgia is inflammation of the tendon at the inner elbow and causes pain at the medial epicondyle but usually lacks numbness in the ulnar digits. Olecranon bursitis presents with swelling at the back of the elbow, not primarily medial elbow pain with a sensory distribution to the ring and little fingers. C5 radiculopathy would involve a different nerve distribution and symptoms arising from the cervical spine rather than from the elbow itself, and wouldn’t typically produce a positive elbow flexion test.

So the combination of medial elbow pain with tingling in the ring and little fingers and a positive elbow flexion test points to cubital tunnel syndrome.