Guyon Canal (Tunnel) Paresthesias in the 4th and 5th At least one of the following exam Syndrome digits (ring and small fingers) findings: without proximal ulnar complaints. Positive at hook of hamate; Tinel’s Numbness or paresthesias of the palm surface of the ring and small fingers; Decreased strength of the adductor pollicis, abductor digiti minimi, and/or lumbricals. Posterior Interosseous Weakness of finger and thumb Weakness or inability to extend fingers, Nerve Entrapment extension thumb or wrist in neutral or ulnar (PIN) deviation; Pronator Syndrome Pain/paresthesias in the median Paresthesias in the median nerve nerve distribution distal to the distribution and at least one of the elbow. following reproduces median nerve symptoms: DIAGNOSIS SYMPTOMS SIGNS (Required Findings) Pronator Syndrome, Resisted pronation with elbow continued flexed at 90 degrees or elbow extended; Positive at the proximal Tinel’s edge of the pronator teres muscle over the median nerve. Radial Tunnel Pain over the lateral posterior The following two elements are Syndrome forearm. May occur in conjunction required: with and must be distinguished from lateral epicondylitis. Tenderness over the radial nerve near the proximal edge of the May include paresthesias over the supinator muscle; dorsal radial hand and wrist. Resisted supination or resisted middle finger extension with the forearm pronated and extended reproduces symptoms.
Guyon Canal (Tunnel) Syndrome Paresthesias in the 4th and 5th digits (ring and small fingers) without proximal ulnar complaints. At least one of the following exam findings: Positive Tinel’s at hook of hamate; Numbness or paresthesias of the palm surface of the ring and small fingers; Decreased strength of the adductor pollicis, abductor digiti minimi, and/or lumbricals. Posterior Interosseous Nerve Entrapment (PIN) Weakness of finger and thumb extension Weakness or inability to extend fingers, thumb or wrist in neutral or ulnar deviation; Pronator Syndrome Pain/paresthesias in the median nerve distribution distal to the elbow. Paresthesias in the median nerve distribution and at least one of the following reproduces median nerve symptoms: DIAGNOSIS SYMPTOMS SIGNS (Required Findings) Pronator Syndrome, continued Resisted pronation with elbow flexed at 90 degrees or elbow extended; Positive Tinel’s at the proximal edge of the pronator teres muscle over the median nerve. Radial Tunnel Syndrome Pain over the lateral posterior forearm. May occur in conjunction with and must be distinguished from lateral epicondylitis. May include paresthesias over the dorsal radial hand and wrist. The following two elements are required: Tenderness over the radial nerve near the proximal edge of the supinator muscle; Resisted supination or resisted middle finger extension with the forearm pronated and extended reproduces symptoms.