Radial neuropathy at the spiral groove: Difference between revisions
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*Possible [[numbness|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== | ||
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==Evaluation== | ==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== | ||
Revision as of 14:30, 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.