Useful diagnostic studies in the evaluation of upper-extremity pain include all of the following, EXCEPT:
Pain in the upper extremity may be of musculoskeletal or neurologic origin. Compression of the nerves supplying the upper extremity can occur at various levels from the spinal cord all the way down to the fingers. Cervical spine x-ray is helpful for detecting bony abnormalities, which may cause nerve compression. Pancoast's tumor, which can be demonstrated on chest x-ray, may be responsible for pain. Neural conduction studies of the median nerve may disclose the presence of carpal tunnel syndrome as the cause of pain. Finkelstein's test produces pain in patients with de Quervain's disease. The test is performed by asking the patient to grab his own thumb with the other fingers of the same hand and then move the wrist in the ulnar direction. If pain is elicited, then the test is positive. Adson's test is very helpful in detecting the presence or absence of collateral circulation between the radial and ulnar aeries and is not diagnostic for pain. Ref: Rapp J.H., MacTagga J. (2010). Chapter 34. Aeries. In G.M. Dohey (Ed),CURRENT Diagnosis & Treatment: Surgery, 13e.
Cervical spine x-rayChest X-ray
Chest X-ray
Neural conduction studies of the median nerve
Adson's test