Neck and Arm Neurology Question

abcxyz · Sep 17, 2013

A 45-year-old man has had a 1-week history of increasing neck pain when he turns his head to the right. He also has had a pins-and-needles sensation starting in the neck and radiating down the right arm into the thumb. His symptoms began 3 months ago when he developed severe pain in the neck and right shoulder. Neurologic examination shows limitation of motion on turning the neck to the right. There is 4+/5 weakness of the right biceps and decreased pinprick over the right thumb. Deep tendon reflexes are 1+ in the right biceps and brachioradialis; all others are 2+. Which of the following is the most likely diagnosis?

(A) Carpal tunnel syndrome
(B) Cervical root compression
(C) Multiple sclerosis
(D) Thoracic outlet syndrome
(E) Ulnar nerve compression

drsrb · Sep 17, 2013

cervical root compression..

Doctor Ali · Sep 17, 2013

My answer is B.

Master shifu · Sep 17, 2013

Cervical root compression most likely

abcxyz · Sep 19, 2013

Yes, answer is Cervical root compression.

How do you differentiate between Cervical root compression and Thoracic outlet syndrome? :redcheeks;

ag2011n · Sep 19, 2013

Thoracic outlet syndrome refers to compression of neuro-vascular structures supplying upper extremity. Pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip, signs of poor circulation in the hand or forearm (a bluish color, cold hands, or a swollen arm). Elevated arm stress test is used for screening of thoracic outlet syndrome.
I hope that help.

Neck and Arm Neurology Question

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