Author: Erek Latzka, MD
Senior Editor: David Siebert, MD
Editor: Mandeep Ghuman, MD, FAMSSM
Patient Presentation:
A 71 year old male badminton player presents with 2 months of slowly progressive right hand pain, numbness in the 4th and 5th digits, and grip weakness; symptoms are exacerbated with badminton, tennis, and golf.
History:
He reports a remote right hand injury one year ago when he was struck by his double's partner's racket. He did not see a doctor, and his pinky finger "later became deformed."
Physical Exam:
On inspection, the patient's 5th digit is abducted. There is atrophy of the right abductor digiti minimi and first dorsal interossei. Sensation is decreased at the right palm and 4th/5th digits. He exhibits decreased right grip strength as well as weakness with 5th finger abduction and 2nd finger abduction. Froment sign and Waterburg sign are positive. Tinel's at the wrist and elbow are negative. Phalen's, Watson's, Finkelstein's, Spurling's, and Hoffman's tests are also negative. Deep tendon reflexes are symmetric bilaterally.
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