Wasting of Hand Muscles
In the context of the respiratory examination, we examine for muscle wasting as a sign of denervation secondary to an apical lung tumour. A Pancoast tumour in the apex of the lung may compress the brachial plexus and result in localised wasting of the hand.
Look For
- Decreased mass of the thenar and/or hypothenar eminence.
Causes of Wasting of Hand Muscles
Localised Wasting
- Median nerve lesion
- Ulnar nerve lesion
- Brachial plexus compression
Generalised Wasting
- Normal aging
- Disuse
- Malnutrition - poor diet, malabsorption, cancer
- Denervation - trauma, motor neuron disease, Guillain-Barre Syndrome, polyneuropathy
- Muscular disorders - inflammatory myositis, muscular dystrophies
- Chronic disease - cancer, heart failure, COPD, infection, cirrhosis, kidney disease
Overview
Tip
- Muscle wasting and shiny skin with reddish discolouration is a very specific for reflex sympathetic dystrophy.
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