A 40-year-old man has 1-month history of progressive left hip and buttock pain radiating to the left thigh. He has 5 kg of unintentional weight loss. His medical history is significant for long-standing uncontrolled TDM. He takes premixed insulin 30/70 twice daily. His recent HbA1c is 10%. On examination, vital signs are stable. Neurologic examination reveals right quadriceps muscle wasting and weakness. He has a difficulty getting up from a squatting position. The knee-jerk reflex is absent. He has a significant sensory loss in his feet bilaterally. Examination of hip joints is unremarkable. Which of the following is the most likely diagnosis of this patient condition?
سؤال مجاني 7 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Diabetic lumbosacral plexopathy
Severe hip/thigh pain, weight loss, quadriceps wasting and weakness (difficulty rising from squat) with an absent knee jerk in a poorly controlled diabetic is diabetic lumbosacral plexopathy (diabetic amyotrophy). Mononeuritis multiplex affects separate individual nerves, and cauda equina would give sphincter/saddle findings. Note: the stem says left-sided pain but right quadriceps wasting (likely a typo); it does not change the answer.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Cauda equina syndrome features saddle anaesthesia and bladder and bowel disturbance; neither is described here.
✓ Basics of Neurology-Ali Rawas.pdf · p. 100 -
B
ليش صح
Lumbar plexopathy in diabetes (diabetic amyotrophy) presents with painful wasting of the quadriceps, weak knee extension and an absent knee reflex.
✓ GBS and MG D.pdf · p. 2 -
C
ليش غلط
Diabetic mononeuropathies involve single named nerves (median, ulnar, common peroneal), while lumbosacral plexopathy gives deep thigh pain with thigh and hip muscle atrophy, as here.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 14
- المصدر
- Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 14
GBS and MG D.pdf · p. 2 - المحاضرة
- Diabetes Mellitus · Endocrinology · Module B
- ظهر في
- Endo bank