Tinel sign for ulnar neuropathy

With the elbow flexed at about 90 degrees and the arm externally rotated, the medial epicondyle and the olecranon process are identified. The ulnar nerve travels within this groove. The examiner taps this area repeatedly with the tip of the finger. Lancinating pain or numbness or an electric sensation that travels along the ulnar nerve distribution (which extends distally as far as the ring and little fingers) marks a positive Tinel sign. Assuming the ulnar neuropathy is unilateral, the sensation should be distinctly different on the uninvolved side.