Cumulative Trauma Disorders of the Upper Extremities

To the Editor. —The article by Rempel et al¹ is a welcome addition to the growing literature on the subject of workrelated arm problems. However, there are some questionable neurological concepts that have recently come under more scrutiny by others.

The authors equate the term "cubital tunnel syndrome" with the more common and accurate diagnosis of "ulnar neuropathy at the elbow." There is some evidence that only a minority of lesions actually occur within the cubital tunnel, and the conflation of these two terms adds to current confusion on the subject.^2,3

Earlier reports of the so-called pronator syndrome have been called into question recently, and the criteria for this syndrome are ill-defined and controversial. For many physicians, it seems to constitute a convenient "wastebasket" for lower arm pain, analogous to the way "thoracic outlet syndrome" has been used for other vague arm pains.^3,4

Some popular but questionable