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Posted by ccf neuro M.D. on May 25, 1997 at 23:03:01:
In Reply to: bilateral thumb/wrist pain posted by T. Ammons on May 15, 1997 at 21:53:38:
: I am an occupational therapist who is treating a 51 y.o.white,premenaposal female dxd with bilateral thumb/wrist pain.PMH is unremarkable except for the continuation of thumb pain for the past 15 years. She went to UNC medical center at that time and was treated by a hand surgeon who could find no cause for her pain(even after performing exploratory surgery on right thumb).She learned to adapt to the pain until apprx. 2 months ago when the pain increased and bilateral wrist involvement began.The wrists hurt when either pushing a drawer closed or lifting even a magazine with a flat palm.She denies having arthritis.She was negative for the "grind" test and negative for the "Finklestein's" ,but could not tolerate thumb distraction on either hand.No edema,deformities,or skin changes noted.Tender points include thenar eminences. She also reported a bout with pain in both big toes that felt like her thumbs but has since resolved. She was checked for gout.She also reported that a co-worker said that she,too,has very similar symptoms.
My 2 questions: 1. Could this be a systemic arthritic,neurological or hormonal condition? I have not been able to find a physician here who knows whats going on. 2.If you can't answer this do you know where on the NET I can ask my question? Thank you for your reply.
There are no neurologic conditions that I am aware of that could produce these symptoms. I cannot comment on systemic endocrine or rheumatologic conditions, as these are outside of my area of medical expertise. Given the lack of any physical exam or even direct surgical exloration evidence of abnormlity, I doubt anyone will be able to attach an organic medical diagnosis to the symptoms you describe in the affected patient. A bone scan might be an interesting thing to try--- if it were negative, the only serious considerations would be psychiatric. Sorry I cannot be of more help. You might try a rheumatology website.
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