A 73 year old man with a three month history of bilateral persistent tingling in the index and middle fingers presented to his general practitioner. He was referred for an injection for suspected carpal tunnel syndrome. When he attended, as well as the tingling sensation, he described loss of fine motor function in his hands, with altered sensation in both legs and his inner thighs. Examination at this time showed no objective sensory loss in either hand. Phalen’s test and Tinel’s test were both negative. His upper limb tendon reflexes were normal.
almost 7 years ago
Introduction Wash hands, check right patient, introduce yourself, get permission Ask the patient to sit up straight in a chair, and expose their neck down to the shoulders. You could ask them to look up a little bit. Remove any jewellery. InspectionInspect the hands Hypothyroidism Lethargic, disinterested Bradycardia (radial pulse)
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over 6 years ago