A 65-Year-Old Man Is Evaluated for Slowly Progressive, Right-Hand Clumsiness

A 65-year-old man is evaluated for slowly progressive, right-hand clumsiness for several months.  Medical history is significant for hypertension and end-stage renal disease, for which he undergoes hemodialysis 3 times a week.  The patient is retired and not physically active.  He does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 130/90 mm Hg and pulse is 80/min.  BMI is 20 kg/m².  Examination shows decreased sensation over the 4th and 5th fingers of the right hand, along with a weaker grip and weaker hand flexion at the wrist compared to the left side.  Overall muscle mass and tone are decreased in all four extremities.  Which of the following is the most likely site of nerve injury?

A) Median nerve at the elbow
B) Median nerve at the wrist
C) Radial nerve at the elbow
D) Radial nerve at the wrist
E) Ulnar nerve at the elbow
F) Ulnar nerve at the wrist

Correct Answer:

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