Differential Diagnosis for Grip Hand Weakness

• Single most likely diagnosis
  • Carpal Tunnel Syndrome: This condition is the most common cause of grip hand weakness, resulting from compression of the median nerve at the wrist, leading to numbness, tingling, and weakness in the hand, particularly affecting the thumb, index, and middle fingers.
• Other Likely diagnoses
  • Radial Neuropathy: Damage to the radial nerve can cause weakness in the extensor muscles of the wrist and fingers, leading to difficulty gripping.
  • Ulnar Neuropathy: Compression or damage to the ulnar nerve can cause weakness and atrophy in the intrinsic muscles of the hand, affecting grip strength.
  • Tendinitis or Tenosynovitis: Inflammation of the tendons or their surrounding sheaths in the hand and wrist can lead to pain and weakness, affecting grip.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Acute Compartment Syndrome: A medical emergency where increased pressure within a muscle compartment can lead to nerve and muscle damage, requiring immediate intervention.
  • Brachial Plexus Injury: Trauma to the brachial plexus can result in severe and potentially permanent weakness or paralysis of the arm and hand.
  • Cervical Radiculopathy: Nerve root compression in the cervical spine can cause radiating pain, numbness, and weakness in the arm and hand, including grip weakness.
• Rare diagnoses
  • Amyotrophic Lateral Sclerosis (ALS): A progressive neurological disease affecting nerve cells in the brain and spinal cord, leading to loss of muscle control, including hand weakness.
  • Multifocal Motor Neuropathy: A rare condition characterized by asymmetric muscle weakness, often affecting the hands, due to damage to multiple motor nerves.
  • Pompe Disease: A genetic disorder leading to the accumulation of glycogen in muscles, causing progressive muscle weakness, which can include grip weakness.