Rucksack-induced plexopathy mimicking a lateral antebrachial cutaneous neuropathy

American Journal of Physical Medicine & Rehabilitation
Arthur Jason De LuigiErik Dahl

Abstract

A 20-yr-old active duty soldier complained of right lateral forearm numbness that began shortly after carrying 100 lbs of equipment (20-lb load-bearing equipment, 20-lb individual body armor, and 60-lb rucksack) while deployed during Operation Iraqi Freedom. Physical examination revealed normal strength but decreased sensation over the right lateral forearm, thumb, and index finger. Imaging studies were normal. Electrodiagnostic studies revealed an absent right lateral antebrachial cutaneous nerve conduction study with abnormal electromyography findings in the right deltoid and biceps brachii. He was diagnosed with an upper trunk brachial plexopathy. The patient's symptoms gradually resolved with conservative treatment. Although rucksack palsies have been previously reported, this relatively rare cause of brachial plexus injury has been generally declining with the reengineering of more ergonomically favorable rucksacks. It is possible that the additional body armor may have contributed.

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Citations

Nov 17, 2009·Anesthesia and Analgesia·Amy Judge, Karamarie Fecho
Sep 8, 2010·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·S Chakravarthy MarxC Anitha Marx
Oct 16, 2013·Journal of the Royal Army Medical Corps·Robert McCullochD Power
Mar 31, 2015·Journal of the Royal Army Medical Corps·Kyoung-Eun Kim, E-J Kim
Dec 24, 2016·Medicine and Science in Sports and Exercise·Amir HadidAmit Gefen
Nov 25, 2020·Military Medicine·Jameson P McSheaMatthew E Miller

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