Question of the Week

For March 2, 2021

A 43-year-old woman reports 6 weeks of tingling and numbness in the first three fingers of her right hand, as well as episodic pain and weakness in the hand and arm. She has no significant medical history.

On examination, she has a normal range of motion at the neck and no Tinel sign at the wrist. She has mild weakness of the right biceps, pronator teres, and brachioradialis. There is no weakness of the intrinsic hand muscles. She has sensory loss of the thumb and forefinger. The bicep jerk is absent, but the rest of the reflexes are normal. The patient’s physical examination is otherwise normal.

Which one of the following diagnoses is most likely in this case?

Carpal tunnel syndrome
C6 cervical radiculopathy
Thoracic spinal cord radiculopathy
Cervical spinal cord injury/myelopathy from a C1 lesion
C8 cervical radiculopathy

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