A 64-year old woman with right hand swelling and paresthesia

Published: 29 July 2015
Author(s): Or Kalchiem-Dekel, Sharon Davidesko, Nimrod Maimon
Section: Internal Medicine Flashcard

A 64-year old woman presented to the emergency department with a 6-month history of right lateral cervical pain and a 2-week history of erythema and swelling of her right hand and wrist, accompanied by a tingling sensation along her right forearm. The patient denied recent occurrence of fever, recent trauma, or strenuous exercise. She appeared comfortable. Her temperature was 36.2°C, blood pressure was 132/70mm Hg, pulse was 89beats/minute and O2 saturation was 98% in ambient room air. Physical examination of the right upper limb revealed mild erythema and non-pitting edema of the hand and wrist as well as decreased sensation to light touch and pain along the C8–T1 dermatomes.