Radial neuropathy at the spiral groove: Difference between revisions
No edit summary |
No edit summary |
||
| (10 intermediate revisions by 5 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
[[File:Nerves of the left upper extremity.gif|thumb|Nerves of the left upper extremity.]] | |||
*Radial nerve predisposed to compression in area where runs next to humerus (i.e. spiral groove) | *Radial nerve predisposed to compression in area where runs next to humerus (i.e. spiral groove) | ||
*Often occurs after prolonged pressure | *Often occurs after prolonged pressure | ||
| Line 5: | Line 6: | ||
==Clinical Features== | ==Clinical Features== | ||
*Weakness of wrist extensors ("wrist drop"), finger extensors, and brachioradialis | [[File:Cutaneous innervation of the upper limb.svg|thumb|Cutaneous innervation of the upper limb]] | ||
*[[Weakness]] of wrist extensors ("wrist drop"), finger extensors, and brachioradialis | |||
*Triceps retains full strength | *Triceps retains full strength | ||
*Possible sensory loss over the dorsum of the hand, sometimes extending up the posterior forearm | *Possible [[numbness|sensory loss]] over the dorsum of the hand, sometimes extending up the posterior forearm | ||
*Thumb abduction is affected (abductor pollicis longus is a radial-innervated muscle) | *Thumb abduction is affected (abductor pollicis longus is a radial-innervated muscle) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[CVA]] | *[[CVA]] | ||
==Workup== | {{Upper extremity peripheral nerve syndromes}} | ||
==Evaluation== | |||
===Workup=== | |||
*Clinical diagnosis | *Clinical diagnosis | ||
===Diagnosis (Vs. [[CVA]])=== | |||
*Relative preservation of triceps strength | |||
*Sensory loss isolated to the dorsum of the hand | |||
*Brachioradialis should also be weak | |||
==Management== | ==Management== | ||
*Wrist splint with 60 degrees of dorsiflexion to avoid contractures<ref>Bunney EB, Gallagher EJ: Peripheral Nerve Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 107: p 1428-1441.</ref> | |||
*Usually spontaneously resolves, but may take 2-4 months, during which splint should be worn | |||
==Disposition== | ==Disposition== | ||
*Discharge with neurology | *Discharge with neurology follow up | ||
==See Also== | ==See Also== | ||
| Line 31: | Line 38: | ||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Neurology]] | ||
Latest revision as of 14:35, 5 February 2022
Background
- Radial nerve predisposed to compression in area where runs next to humerus (i.e. spiral groove)
- Often occurs after prolonged pressure
- Frequently from inebriated individuals sleeping with arm resting on hard surface (i.e. "Saturday night palsy")
Clinical Features
- Weakness of wrist extensors ("wrist drop"), finger extensors, and brachioradialis
- Triceps retains full strength
- Possible sensory loss over the dorsum of the hand, sometimes extending up the posterior forearm
- Thumb abduction is affected (abductor pollicis longus is a radial-innervated muscle)
Differential Diagnosis
Upper extremity peripheral nerve syndromes
Median Nerve Syndromes
Ulnar Nerve Syndromes
Radial Nerve Syndromes
- Radial neuropathy at the spiral groove (ie. "Saturday night palsy")
- Posterior interosseous neuropathy
Proximal Neuropathies
- Suprascapular neuropathy
- Long thoracic neuropathy
- Axillary neuropathy
- Spinal accessory neuropathy
- Musculocutaneous neuropathy
Other
Evaluation
Workup
- Clinical diagnosis
Diagnosis (Vs. CVA)
- Relative preservation of triceps strength
- Sensory loss isolated to the dorsum of the hand
- Brachioradialis should also be weak
Management
- Wrist splint with 60 degrees of dorsiflexion to avoid contractures[1]
- Usually spontaneously resolves, but may take 2-4 months, during which splint should be worn
Disposition
- Discharge with neurology follow up
See Also
External Links
References
- ↑ Bunney EB, Gallagher EJ: Peripheral Nerve Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 107: p 1428-1441.