01974nas a2200265   4500000000100000008004100001260001300042653003900055653001500094653001600109653002600125653002800151653001100179653001200190653003200202653001600234653003900250653002000289100001300309700001200322245011400334490000700448520123900455022001401694       2009                            d  c2009 Oct10aAcquired Immunodeficiency Syndrome10aAlcoholism10aComorbidity10aDiabetic Neuropathies10aDiagnosis, Differential10aHumans10aleprosy10aNerve Compression Syndromes10aOrthopedics10aPeripheral Nervous System Diseases10aUpper Extremity1 aBales JG1 aMeals R00aPeripheral neuropathy of the upper extremity: medical comorbidity that confounds common orthopedic pathology.0 v323 a<p>In the orthopedic patient, the diagnosis of a compression neuropathy may be straightforward. However, various medical comorbidities can obscure this diagnosis. It is paramount for the practicing orthopedic surgeon to have an appreciation for the medical pathology of common axonal neuropathies to properly diagnose, treat, and refer a patient with altered sensation in the upper extremity. The prevalence of diabetes in the United States is 10%, and roughly 20% of diabetic patients have peripheral neuropathy. In addition to diabetes, 32% of heavy alcohol users present with polyneuropathy. With advancements in the treatment of human immunodeficiency virus/acquired immunodeficiency syndrome clinicians may see the long-term effects of the virus manifested as axonal neuropathies and extreme allodynia. In some regions of the world, Hansen's disease usurps diabetes as the most common cause of polyneuropathy. Based on patient demographics and social habits, Lyme disease, multiple sclerosis, and syphilis can all manifest as polyneuropathies. Understanding the common medical causes of neuropathy will aid the orthopedic surgeon in differentiating simple compression neuropathies from diseases mimicking or confounding them.</p>  a1938-2367