Hand Tingling
Age: years old
Gender:
HISTORY:
Presents with a - history of hand
Location is on
Type of sensation is
Onset is and is
Worsening factors:
Alleviating factors: ,
Associated symptoms: *Try using right-click for negatives*
Contributing factors:
no history of: , , , , , ,
no use of: , ,
EXAM:
Wrist:
Inspection:
Palpation: on
Range of motion:
- Flexion:
- Extension:
- Ulnar deviation:
- Radial deviation:
Sensation: over
Strength: throughout upper extremities, except on
Reflexes: throughout upper extremities, except on
Special tests:
- Phalen test:
- Tinel sign:
- Carpal compression test:
ASSESSMENT:
DDx: carpal tunnel syndrome, ulnar tunnel syndrome at the elbow, Guyon's canal syndrome radial nerve neuropathy, cervical radiculopathy, peripheral neuropathy, Raynaud's phenomenon, thoracic outlet syndrome, tendonitis, de Quervain's tenosynovitis, flexor tenosynovitis, osteoarthrosis, diabetic neuropathy, vascular insufficiency, complex regional pain syndrome, ganglion cyst, alcohol-related neuropathy, hypothyroidism
PLAN:
Investigations:
- Blood work: , , ,
- Nerve conduction study
- EMG
- Cervical spine X-ray
- MRI of the cervical spine
Treatments:
-
-
- Physical therapy
- Occupational therapy
- Wrist splint for carpal tunnel syndrome
Further care:
- Referral to neurologist
- Referral to orthopedic surgeon
- Referral to plastic surgeon
- Follow-up in
- Return if numbness worsens, if new symptoms develop such as weakness or pain, or if symptoms do not improve with treatment
HISTORY: Associated symptoms: EXAM: Wrist: ASSESSMENT: PLAN: