Question

multiple choice question
a 50 - year - old female presents with complaints of numbness and tingling in her thumb, index, and middle fingers, especially at night. she reports weakness in her grip and dropping objects more frequently. on physical examination, tinels sign and phalens test are positive. which of the following is the most likely diagnosis?
please select your answer...
a cubital tunnel syndrome
b carpal tunnel syndrome
c de quervains tenosynovitis
d trigger finger

Explanation:

• Carpal tunnel syndrome: Characterized by median nerve compression. Symptoms include numbness/tingling in thumb, index, middle fingers (median nerve distribution), grip weakness. Tinel's sign (tapping over carpal tunnel causing paresthesia) and Phalen's test (wrist flexion causing symptoms) are classic tests for carpal tunnel syndrome.
• Cubital tunnel syndrome: Involves ulnar nerve compression at elbow. Symptoms would be in ulnar - innervated areas (ring and little fingers mainly), not the distribution described here.
• De Quervain’s tenosynovitis: Affects the abductor pollicis longus and extensor pollicis brevis tendons. Pain is at the radial styloid (base of thumb), Finkelstein’s test is positive (not Tinel’s or Phalen’s).
• Trigger finger: Caused by stenosis of flexor tendon sheath. Presents with finger locking/catching, not the sensory and grip symptoms described here.

Answer:

B. Carpal tunnel syndrome