Get this App offline and editable on your phone

iPhone & iPad | Android | PC | Mac

Numbness and tingling

  • Common ddx

    • diabetic neuropathy, B12 deficiency, pinched nerve, positional nerve compression
  • Serious ddx

    • cauda equina, MS, myelopathy
  • Labs

    • consider MRI
    • CBC, Chem, ESR
    • glc, a1c
    • B12, folate
    • TSH
    • lead, arsenic, heavy metal levels
    • LP if suspect MS, GBS
    • consider urine porphyrins
    • consider EMG
  • Nerve compression ddx

    • from position, herniated disk, tumor, osteoarthritis, carpal tunnel, ulnar nerve entrapment, tarsal tunnel
  • Vascular compression ddx

    • thoracic outlet syndrome
  • Mononeuropathy ddx

    • carpal tunnel, tarsal tunnel, ulnar neuropathy, radial neuropathy, pinched nerve
  • Polyneuropathy ddx

    • GBS, MS, diabetic neuropathy, Charcot-Marie-Tooth, CIDP, lead poisoning, B12 deficiency
  • Upper extremity ddx

    • carpal tunnel syndrome, ulnar nerve entrapment, Raynaud's syndrome
  • Lower extremity ddx

    • restless leg syndrome, sciatica, tarsal tunnel
  • Other ddx

    • GBS, myelopathy, syringomyelia, hyperthyroidism, shingles prodrome
  • HPI

    • onset: acute vs chronic, new vs old
    • location
    • unilateral vs bilateral
    • quality: pain, burning, associated weakness
    • severity
    • aggravates, alleviates
  • ROS

    • fever, fatigue, weight loss, recent infection
    • rash, pallor
    • vision changes
    • chest pain, dyspnea
    • diarrhea, nausea, vomiting, abdominal pain
    • paresis, focal weakness, incontinence, lhermitte's (shock sensation down the back and limbs when flex neck)
  • Upper extremity ROS

    • neck pain
    • arm pain
    • wrist pain
    • discoloration of fingers
  • Lower extremity ROS

    • back pain
    • leg pain
    • ankle pain
    • restless legs at night
  • PMH

    • diabetes
    • neuropathy
  • FH

    • diabetes
  • SH

    • EtOH
    • vegan diet
    • work, exposure to insecticides
    • poor position or posture
  • Meds

  • Allergies

  • Px

    • vitals
    • gen impression
    • rash, pallor
    • thyroid nodules
    • cardio: strength of pulse, unequal pulse
    • pulm
    • abd
    • strength, reflex, sensation over dermatomes
  • Upper extremity px

    • percussion over wrist, ulnar nerve
  • Lower extremity px

    • straight leg test

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.