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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The diagnosis of carpal tunnel syndrome is via clinical evaluation and sometimes, nerve conduction testing. The Tinel sign is very suggestive, in which paresthesias are reproduced by tapping on the volar surface of the wrist above the site of the median nerve (see Figure 13.2). Wrist flexion (the Phalen sign) can reproduce tingling, as can direct pressure (the median nerve compression test). Nerve condition testing is done for severe symptoms, an uncertain diagnosis, or to exclude a more proximal neuropathy. Diagnosis of Dupuytren contracture is via clinical examination. Adhesive capsulitis is diagnosed by history and physical examination, excluding other shoulder conditions. The movement that is most severely prevented is external rotation of the shoulder. Imaging features can be seen on ultrasound or noncontrast MRI. There may be fibrosis and thickening at the axillary pouch and rotator interval. Hypoechoic material around the long head of the bicep tendon is diagnostic. For sclerodactyly, diagnosis based on clinical examination.
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Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Tinel Sign In carpel tunnel syndrome, tapping over the carpel tunnel causes paraesthesia over the median nerve distribution of the hand. Described by French neurologist, Jules Tinel (1879–1952) from Rouen who practiced at Paris.
Peripheral nerve disorders
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
A 68-year-old female presented with 5 years of progressive pain and paresthesias involving the medial surface of her left foot. She underwent several negative lumbar magnetic resonance imaging (MRI) scans and resection of her navicular bone in an attempt to treat her pain. A mass was discovered along the medial aspect of her lower leg, and a MRI revealed a homogenously enhancing lesion involving the tibial nerve (Figure 70.1a). There was no history of medical problems and no family history of tumors or cutaneous lesions. Physical exam reveals a small, mildly tender mass located on the posteromedial surface of the left lower leg. She had full strength and normal sensation. Tinel sign is positive over the lesion and reproduced her symptoms.
Short-term effects of dry needling of thenar muscles in manual laborers with carpal tunnel syndrome: a pilot, randomized controlled study
Published in Physiotherapy Theory and Practice, 2023
Maedeh Rezazadeh, Atefeh Aminianfar, Daryoush Pahlevan
The participants enrolled in the study based on history, physical examination, and nerve conduction study (NCS), diagnosed by a physician as CTS. The diagnostic NCV tests were as follows: distal motor latency ≥4 ms, distal sensory latency ≥3.6 ms, and W-P SNCV < 41 ms (Keith et al., 2009). The following criteria were considered as the clinical diagnosis of CTS: 1) positive Tinel sign and Phalen test; 2) numbness and tingling in fingers and median nerve compression (Tetro, Evanoff, Hollstien, and Gelberman, 1998); 3) presence of a fairly unique set of criteria (i.e. taut band, local tenderness, patient pain recognition, and pain referral) (Donnelly, Fernandez-de-las-penas, Finnegan, and Freeman, 2019), or referred pain from trapped thenar branch of median nerve (Mumford, Morecraft, and Blair, 1987)).
Rare case of Intraneural Lipoma of Digital Nerve
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Yu-Jung Su, Laxminarayan Bhandari
A 68-year-old man presented to our clinic with a mass on both the volar and dorsal surface of the right ring finger for 2 years. The mass was gradually enlarging. He reported no pain or numbness but had cold intolerance over the mass. Patient denied any trauma. On examination, the mass was noted to be 2 cm × 1 cm at the volar aspect of the middle phalanx. It had a dorsal extension of 1 cm × 1 cm. Right ring finger had a full range of motion. The sensation was normal with 2-point discrimination same as that of the other fingers. On palpation, the mass was firm, painless, immobile, non-translucent, non-pulsatile. There was no tinel sign. Magnetic resonance imaging demonstrated a 2.4 × 1.5 × 2.7 cm multilobulated mass with predominantly hypointense in T2-weighted images and hyperintense in T1- weighted images (Figure 1). These characteristics were suggestive of a lipoma.
Ultrasound-guided percutaneous electrical stimulation for a patient with cubital tunnel syndrome: a case report with a one-year follow-up
Published in Physiotherapy Theory and Practice, 2022
César Fernández-de-Las-Peñas, José L. Arias-Buría, Youssef Rahou El Bachiri, Gustavo Plaza-Manzano, Joshua A. Cleland
The first diagnostic hypothesis was an ulnar neuropathy compatible with a cubital tunnel syndrome; therefore, provocative tests for ulnar neuropathy were performed (Novak, Lee, Mackinnon, and Lay, 1994). He exhibited a positive Tinel sign (sensitivity 0.70, specificity 0.98) and a positive elbow flexion compression test (sensitivity: 0.89; Specificity: 0.98) over the cubital tunnel. In addition, the upper limb nerve tension test with ulnar nerve bias (ULNT3) reproduced the patients’ numbness and tingling (Nee, Jull, Vicenzino, and Coppieters, 2012). According to signs and symptoms presented by the patient and the clinical examination, he was diagnosed with Grade one (i.e. paresthesia on little and ring fingers associated with sensations of discomfort and clumsiness in the hand) and two (i.e. weakness and wasting of intrinsic hand muscles) ulnar neuropathy (McGowan, 1950).