Management Decisions in Nontraumatic Complaints of Arm, Neck, and Shoulder in General Practice

Anita Feleus; Sita M. A. Bierma-Zeinstra; Roos M. D. Bernsen; Harald S. Miedema; Jan A. N. Verhaar; Bart W. Koes

doi:10.1370/afm.993

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

What code is in the image? *

Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

An Ignored Common Cause of Arm,Neck and Shoulder Pain
Carlos A Selmonosky,MD

Published on: 24 September 2009

Published on: (24 September 2009)
Page navigation anchor for An Ignored Common Cause of Arm,Neck and Shoulder Pain
An Ignored Common Cause of Arm,Neck and Shoulder Pain
Carlos A Selmonosky,MD, Falls Church,Va,USA
The physical examination in these patients requires the testing of the strength of the fifth finger.Weakness of the fifth finger is due to Thoracic Outlet Syndrome(TOS),Ulnar entrapment at the elbow or at the wrist and very rare unilateral lesion of C8.TOS is a common cause of neck,shoulder,chest and upper extremity pain.It diagnosis at the Clinicians Office can be made by the performing a diagnostic triad:1) weakness o...
Show More

The physical examination in these patients requires the testing of the strength of the fifth finger.Weakness of the fifth finger is due to Thoracic Outlet Syndrome(TOS),Ulnar entrapment at the elbow or at the wrist and very rare unilateral lesion of C8.TOS is a common cause of neck,shoulder,chest and upper extremity pain.It diagnosis at the Clinicians Office can be made by the performing a diagnostic triad:1) weakness of the fifth finger,2)paresthesias,numbness,tiredness of the upper extremity on elevation of the hands,associated or not with paleness of the hands,3)tenderness on palpation of the supraclavicular area.Extreme paleness of the hand is called the White Hand Sign.Each of these entrapment neuropathies of the upper extremity,specially TOS need different types of therapy. Therefore , a diagnosis of TOS should be ruled out in all patients complaining of neck,shoulder,chest and upper extremity pain. www.tos- syndrome.com Selmonosky C A.The White Hand Sign.A new single manuever useful in the diagnosis of thoracic outlet syndrome.South Med J.2002,85:557(Abstract)
Competing interests: None declared
Show Less

Competing Interests: None declared.