Musculus anconeus epitrochlearis accesorius

The anconeus epitrochlearis is an accessory muscle at the medial aspect of the elbow. It is also known as the accessory anconeus muscle or epitrochleoanconeus muscle and should not be confused with the anconeus muscle which is present at the lateral aspect of the elbow.

Epidemiology

The muscle may be unilateral but has been found to be bilateral in one of four patients with cubital tunnel syndrome . It is present in ~15% (range 3-28%) of the population .

Clinical presentation

It can be asymptomatic or symptomatic when there is compression of the ulnar nerve within the cubital tunnel, leading to ulnar neuritis.

Gross anatomy

  • origin: medial epicondyle (inferior surface)
  • insertion: olecranon (medial cortex)

Forms the roof of the cubital tunnel when present, running superficial to the ulnar nerve in the posteromedial aspect of the elbow.

Radiographic features

Ultrasound

Thin hypoechoic mass superficial to the ulnar nerve. May also demonstrate underlying ulnar nerve changes (thickening and edema) suggestive of cubital tunnel syndrome .

MRI

Axial MR images may demonstrate a mass superficial to the cubital tunnel, where there should normally only be fat.

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