Differential Diagnosis for Intermittent Tingling in the Elbow to 4th and 5th Finger and Thumb
- Single most likely diagnosis:
- Ulnar nerve compression or irritation: Given the patient's history of bilateral ulnar neuritis and the specific distribution of tingling (elbow to 4th and 5th finger), this diagnosis is highly plausible. The ulnar nerve supplies these areas, and compression or irritation, possibly exacerbated by overexertion with weights, could cause the symptoms.
- Other Likely diagnoses:
- Median nerve compression or irritation: Although the primary complaint involves areas typically associated with the ulnar nerve, the involvement of the thumb suggests possible median nerve involvement. Overuse or improper form during the bench press could lead to median nerve compression.
- Brachial plexus strain or injury: The brachial plexus is a network of nerves that originates in the spinal cord and controls muscle movements and sensation in the shoulder, elbow, wrist, and hand. Overexertion, especially with heavy weights, could potentially strain or injure the brachial plexus, leading to the described symptoms.
- Do Not Miss diagnoses:
- Cervical radiculopathy: Nerve root compression in the cervical spine can cause symptoms similar to those described, including tingling and numbness in specific distributions. It's crucial to consider this diagnosis, as untreated cervical radiculopathy can lead to chronic pain and neurological deficits.
- Thoracic outlet syndrome (TOS): TOS involves compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the thoracic outlet area, which lies between your collarbone (clavicle) and first rib. This could potentially cause the symptoms described, especially if the patient's overexertion led to swelling or strain in this area.
- Rare diagnoses:
- Peripheral neuropathy: Although less likely given the acute onset and specific distribution of symptoms, peripheral neuropathy could potentially cause similar symptoms. This would be more concerning if the patient had underlying conditions such as diabetes or if the symptoms were more widespread.
- Nutritional deficiencies (e.g., vitamin B12 deficiency): Certain nutritional deficiencies can cause neurological symptoms, including tingling and numbness. However, these would typically be part of a broader constellation of symptoms and might not be directly related to overexertion with weights.