Peripheral neuropathy OR carpal tunnel?

[stronghold]

64 year old male, with chronic Diabetes, came to your office complaining of numbness on the tip of his fingers. Neurological examination of feet was normal. Normal vibration sense in all limbs. Dx?

A) Peripheral neuropathy
B) Carpal Tunnel Syndrome

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[Brain Bucket]

Is that all the relevant info? If so, Carpal tunnel. 1. Starts in upper vs lower limbs. 2. Normal vibration perception. Not enough for a diagnosis, but should be enough for a 'best answer' methinks.

 

[MD22412]

Nothing in the question stem indicates carpal tunnel. I would go diabetes (peripheral neuropathy).

Also, carpal tunnel would be median nerve, thus affecting only half of finger tip 4, and tips of phalanges 1-3. Therefore, pinky would not be tingly. Should be A.

 

[Brain Bucket]

That'd be my knee-jerk response too, but with the info given...

What's the answer, anyway?

 

[sanj238]

64 year old male, with chronic Diabetes, came to your office complaining of numbness on the tip of his fingers. Neurological examination of feet was normal. Normal vibration sense in all limbs. Dx?

A) Peripheral neuropathy
B) Carpal Tunnel Syndrome

I think this is very straightforward. Chronic diabetes makes me think peripheral neuropathy which affects in a glove and stocking position- long nerves (longer to travel) attacked first.

 

[Modeselektor]

they will give you more info than this.