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Wrist Drop

Topic: Anatomy

Created on Wednesday, January 3 2007 by

Last modified on Wednesday, January 3 2007.

A 55 year-old male zookeeper presents with wrist and finger drop.
He is able to extend his arm at the elbow.
Abduction of the upper extremity at the shoulder is intact.
He is completely unable to extend the wrist.
Flexion of the wrist is intact.
Sensation is decreased on the lateral dorsal hand.

Of the following options, which is the most appropriate diagnosis?

 
        A) C7 radiculopathy
 
        B) Radial neuropathy at the spiral groove
 
        C) Posterior cord lesion
 
        D) Radial neuropathy in the axilla
 
        E) Posterior interosseous neuropathy
 

 


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This question was created on January 03, 2007 by .
This question was last modified on January 03, 2007.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) C7 radiculopathy

This answer is incorrect.


This patient has a radial neuropathy at the spiral groove. In C7 radiculopathy, elbow extension is impaired, but in this patient it is intact. In C7 radiculopathy, wrist flexion is impaired, but in this patient it is intact. In C7 radiculopathy, sensation is variably decreased on the lateral dorsal hand and posterior arm, but in this patient it is decreased on the lateral dorsal hand.   (See References)

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B) radial neuropathy at the spiral groove

This answer is correct.


This patient has radial neuropathy at the spiral groove. In radial neuropathy at the spiral groove, extension of the arm at the elbow is intact, abduction of the shoulder is intact, wrist extension is likely to be absent, wrist flexion is intact, and sensation is decreased on the lateral dorsal hand.   (See References)

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C) posterior cord lesion

This answer is incorrect.


This patient has a radial neuropathy at the spiral groove. In posterior cord lesion, elbow extension is impaired, but in this patient it is intact. In posterior cord lesion, shoulder abduction is impaired, but in this patient it is intact. In posterior cord lesion, sensation is decreased on the lateral dorsal hand and posterior arm, but in this patient it is decreased on the lateral dorsal hand.   (See References)

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D) radial neuropathy in the axilla

This answer is incorrect.


This patient has a radial neuropathy at the spiral groove. In radial neuropathy in the axilla, elbow extension is impaired, but in this patient it is intact. In radial neuropathy in the axilla, sensation is decreased on the lateral dorsal hand and posterior arm, but in this patient it is decreased on the lateral dorsal hand.   (See References)

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E) posterior interosseous neuropathy

This answer is incorrect.


This patient has a radial neuropathy at the spiral groove. In posterior interosseous neuropathy, wrist extension is partially spared with radial deviation, but in this patient it is absent. In posterior interosseous neuropathy, sensation is intact, but in this patient it is decreased on the lateral dorsal hand.   (See References)

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References:

1. Preston, D.C., and Shapiro, B.E. (2005). Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations, 2nd Edition. Elsevier, Philadelphia.
2. Moore, K.L. (1992). Clinical Oriented Anatomy, 3rd Edition. Williams & Wilkins, Baltimore.
3. Guarantors of Brain. (2000). Aids to the Examination of the Peripheral Nervous System, fourth edition. W.B. Saunders, Edinburgh.
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anatomy
Wrist Drop
Question ID: 01030700
Question written by . (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 01/03/2007
Modified: 01/03/2007
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