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Entrapment Neuropathies 02

Topic: Adult

Created on Friday, January 25 2008 by jdmiles

Last modified on Friday, January 25 2008.

A 72 year-old man presents with numbness and tingling of the 4th and 5th fingers of the right hand, and some weakness of the same hand. The symptoms have been growing slowly worse over the past few months. On exam, there is loss of sensation in these fingers, and on the medial aspect of the hand. There is some atrophy of the hypothenar eminence. Of the following options, which is the most likely diagnosis?

 
        A) Carpal tunnel syndrome
 
        B) Ulnar entrapment neuropathy at the wrist
 
        C) Ulnar entrapment neuropathy at the elbow
 
        D) Posterior interosseous nerve entrapment
 
        E) Proximal median nerve entrapment
 

 


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This question was created on January 25, 2008 by jdmiles.
This question was last modified on January 25, 2008.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) carpal tunnel syndrome

This answer is incorrect.


Carpal tunnel syndrome should not cause paresthesias of the 5th digit.  (See References)

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B) ulnar entrapment neuropathy at the wrist

This answer is incorrect.


Ulnar entrapment neuropathy at the wrist is less common than ulnar entrapment neuropathy at the elbow.  (See References)

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C) ulnar entrapment neuropathy at the elbow

This answer is correct.


Of the choices provided, this patient's symptoms are most easily explained by an ulnar entrapment neuropathy at the elbow (cubital tunnel syndrome).  (See References)

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D) posterior interosseous nerve entrapment

This answer is incorrect.


Neuropathy of the posterior interosseous nerve should not cause paresthesias.  (See References)

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E) proximal median nerve entrapment

This answer is incorrect.


Proximal median nerve entrapment should not cause paresthesias of the 5th digit.  (See References)

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References:

1. Biller, J. (2005). Practical Neurology DVD Reveiew. Lippincott Williams & Wilkins, Philadelphia. (ISBN:0781757533)Advertising:
2. Preston, D.C., and Shapiro, B.E. (2005). Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations, 2nd Edition. Elsevier, Philadelphia. (ISBN:075067492X)Advertising:
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adult
Entrapment Neuropathies 02
Question ID: 012508081
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 01/25/2008
Modified: 01/25/2008
Estimated Permutations: 360

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