Pain in the forearm 05

Topic: Adult

Created on Saturday, April 18 2009 by jdmiles

Last modified on Saturday, April 18 2009.

 
        A) This study is suggestive of peripheral polyneuropathy
 
        B) This is an inconclusive study, and no further testing needs to be done at this time
 
        C) This study excludes a median mononeuropathy at the wrist
 
        D) A median/ulnar 2nd lumbrical/interosseous comparison study should be performed
 
        E) This study confirms a median mononeuropathy at the wrist
 

 

	= Go back to the top of the page.
	= Reload a different version of this question ().
	= Load a random question from the database.
	= Use this question as a template to create a totally NEW question.
	= Enter detailed rating for this question!
	= How users like you have rated this question.

This question was created on April 18, 2009 by jdmiles.
This question was last modified on April 18, 2009.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS

---

A) This study is suggestive of peripheral polyneuropathy

This answer is incorrect.

This patient has symptoms suggestive of a median mononeuropathy at the wrist, consistent with a clinical diagnosis of Carpal Tunnel Syndrome (CTS). Her median motor and sensory studies are normal. This does not exclude the diagnosis of a median mononeuropathy at the wrist. At this point, additional comparison studies should be performed to increase the diagnostic yield of the nerve conduction study. Comparison studies that could be performed at this point include the median/ulnar 2nd lumbrical/interosseous study, the median-versus-ulnar digit 4 sensory comparison study, the median-versus-radial digit 1 sensory comparison study, and the median-versus-ulnar palmar comparison study. Performing at least 3 comparison studies increases the sensitivity for detecting CTS to 97%.  (See References)

Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 

---

B) This is an inconclusive study, and no further testing needs to be done at this time

This answer is incorrect.

This patient has symptoms suggestive of a median mononeuropathy at the wrist, consistent with a clinical diagnosis of Carpal Tunnel Syndrome (CTS). Her median motor and sensory studies are normal. This does not exclude the diagnosis of a median mononeuropathy at the wrist. At this point, additional comparison studies should be performed to increase the diagnostic yield of the nerve conduction study. Comparison studies that could be performed at this point include the median/ulnar 2nd lumbrical/interosseous study, the median-versus-ulnar digit 4 sensory comparison study, the median-versus-radial digit 1 sensory comparison study, and the median-versus-ulnar palmar comparison study. Performing at least 3 comparison studies increases the sensitivity for detecting CTS to 97%.  (See References)

Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 

---

C) This study excludes a median mononeuropathy at the wrist

This answer is incorrect.

This patient has symptoms suggestive of a median mononeuropathy at the wrist, consistent with a clinical diagnosis of Carpal Tunnel Syndrome (CTS). Her median motor and sensory studies are normal. This does not exclude the diagnosis of a median mononeuropathy at the wrist. At this point, additional comparison studies should be performed to increase the diagnostic yield of the nerve conduction study. Comparison studies that could be performed at this point include the median/ulnar 2nd lumbrical/interosseous study, the median-versus-ulnar digit 4 sensory comparison study, the median-versus-radial digit 1 sensory comparison study, and the median-versus-ulnar palmar comparison study. Performing at least 3 comparison studies increases the sensitivity for detecting CTS to 97%.  (See References)

Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 

---

D) A median/ulnar 2nd lumbrical/interosseous comparison study should be performed

This answer is correct.

This patient has symptoms suggestive of a median mononeuropathy at the wrist, consistent with a clinical diagnosis of Carpal Tunnel Syndrome (CTS). Her median motor and sensory studies are normal. This does not exclude the diagnosis of a median mononeuropathy at the wrist. At this point, additional comparison studies should be performed to increase the diagnostic yield of the nerve conduction study. Comparison studies that could be performed at this point include the median/ulnar 2nd lumbrical/interosseous study, the median-versus-ulnar digit 4 sensory comparison study, the median-versus-radial digit 1 sensory comparison study, and the median-versus-ulnar palmar comparison study. Performing at least 3 comparison studies increases the sensitivity for detecting CTS to 97%.  (See References)

Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 

---

E) This study confirms a median mononeuropathy at the wrist

This answer is incorrect.

This patient has symptoms suggestive of a median mononeuropathy at the wrist, consistent with a clinical diagnosis of Carpal Tunnel Syndrome (CTS). Her median motor and sensory studies are normal. This does not exclude the diagnosis of a median mononeuropathy at the wrist. At this point, additional comparison studies should be performed to increase the diagnostic yield of the nerve conduction study. Comparison studies that could be performed at this point include the median/ulnar 2nd lumbrical/interosseous study, the median-versus-ulnar digit 4 sensory comparison study, the median-versus-radial digit 1 sensory comparison study, and the median-versus-ulnar palmar comparison study. Performing at least 3 comparison studies increases the sensitivity for detecting CTS to 97%.  (See References)

Please log in if you want to rate questions.

 

 

 

 

References:

1. Preston, D.C., and Shapiro, B.E. (2005). Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations, 2nd Edition. Elsevier, Philadelphia. (ISBN:075067492X)

Advertising:

Please log in if you want to rate questions.

 

FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
adult
Pain in the forearm 05
Question ID: 041809078
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 04/18/2009
Modified: 04/18/2009
Estimated Permutations: 360