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Diagnostic pitfalls for the hand surgeon

Neurological and other medical disorders are occasionally mistaken for hand conditions. A correct diagnosis is crucial in planning and instituting treatment. This paper will discuss specific conditions and highlight some common pitfalls.

Neurological conditions like Parkinson’s Disease (PD) and stroke may present with signs and symptoms confined to the upper limb. Sensory complaints such as pain may predominate in the early stages of PD, amyotrophic lateral sclerosis and syringomyelia. Certain medical diseases may cause, predispose to or mimic entrapment syndromes. Connective tissue disorders and other immune-mediated neuropathies are ill-defined in the early stages and may pose diagnostic challenges.

Precise diagnosis requires global assessment of the patient, combined with attention to gait, stance and coordination. Electrophysiological studies can provide further elucidation. When in doubt, prompt referral to the appropriate specialist is indicated.

Early recognition will prevent unnecessary detours to the goal of proper treatment. In some cases, a timely diagnosis may avert unnecessary surgery.

Author information

Correspondence to Lee Moon Keen.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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  • Neuropathy
  • Amyotrophic Lateral Sclerosis
  • Global Assessment
  • Proper Treatment
  • Syringomyelia