Solve the Medical Riddle: Her Left Shoulder and Arm Are Painful and Her Fingers Tingle, Third Week
Editor’s note: Welcome to our ThirdAge feature that gives you a chance to play medical sleuth as we share the details of what happened when a patient presented with a problem that stumped the physician at first.
The first week of this riddle, the patient reported her symptoms to a doctor who referred Diane to a physiatrist, a specialist in non-surgical physical medicine and rehabilitation. The second week, the physiatrist proceeded with the examination using the classic S-O-A-P notes as follows:
S=Symptoms or Chief Complaint
A=Assessment or Analysis
P=Treatment Plan or Recommendations
This week, we’ll let you know what some people have suggested as possible diagnoses. Next week, the specialist will reveal the actual diagnosis. Then we’ll begin a new riddle for the following month!
Some Guesses as to What the Diagnosis Will Be
“The doctor and the specialist didn’t mention whether or not Diane has thyroid disease. I was diagnosed with hypothyroidism that contributed to a condition called median neuropathy that impinged on my nerves and caused symptoms a lot like what Diane describes.”
— Lillian K.
“Maybe Diane has bursitis. About a year ago, I started having pain in my upper right arm that turned out to be bursitis. I was aware that bursitis meant ‘inflammation of the bursa sac’ but I thought those fluid-filled sacs were only at our joints. My doctor told me that there are bursa sacs under muscles to facilitate gliding of the nerves. Who knew? Interesting! My bursitis was under the part of the dorsal muscle in the arm. As far as we could tell, I got it from repetitive stress. I’m an avocational violinist and I bow with my right arm. Rest is what finally cured me.”
— Katie R.
“Does Diane have a long neck? My sister, who is now in her late 50s, was a ballerina and she has that typical ballerina long neck. When she was 52, she got something called age-related cervical spondylosis, which means an arthritic neck that can cause nerve encroachment and arm pain. Diane’s X-ray did show some arthritis of the neck, so maybe that’s the problem.”
— Suzanne J.
“I hope I’m wrong, but maybe Diane has cancer. I have a friend who had spinal metastases – bone cancer in her vertebra.”
— Georgia M.
“I was going to say carpal tunnel because she types a lot but that’s usually affects just the wrist and hand, I believe. She does have tingling in her fingers, though, so may she has carpal tunnel and also some repetitive stress all the way up her arm from playing tennis, especially if she hits the ball overhand.”
— Maureen D.