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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Arm Pain, Numbness In Fingers. Chest X-ray Normal. Pinched Nerve?

Hello, I am a 33 year old female, non-smoker. I am concerned that I may have a pancoast tumor in my lungs. This is a special type of tumor that sits at the apex of the lungs. I have had 5 chest xrays over the last 2 months, all of them were clean. My doctor won t send me for a CT scan because he says that he doesn t want to expose me to unnecessary radiation . My symptoms include: a burning pain in my right arm and numbness in the last two fingers on my right hand that started at the end of January. The burning and numbness in the right arm have since went away. Now my neck, right shoulder, right upper part of my chest and right arm are sore. My doctor believes this may be caused by a pinched nerve in my neck and muscle spasms/tension. I go for am MRI of the brain and c- spine next week. An EMG on my right arm showed mild carpal tunnel and a right shoulder xray and ultrasound were clean. I am concerned because I still have many right sided symptoms. I have had multiple clean chest x-rays but know that chest x-rays sometimes miss tumors at the apex of the lungs, such as pancoast. Do you think I should believe the 5 clean x-rays? Could this be a pinched nerve? Worried and scared. Michelle
Mon, 29 Jul 2013
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General & Family Physician 's  Response
Dear Michelle,

First of all, please do not get concerned with the possibility of having a Pancoast tumor.
As you had undergone 5 X rays & all of them reveal normal findings.

The symptoms as mentioned in your post can be attributed to:
1. Neuropathy or nerve compression- as suspected by your doctor.
2. Dietary deficiency of certain nutrients like Iron, Vit B6, Vit B12, Folic acid, etc. which help in blood formation and nerve conduction.
3.Systemic causes like diabetes or hypertension
4. Hypocalcemia- decrease in calcium levels in the body
5. Metabolic & Hormonal causes

Though symptomatic relief can be obtained by administration of nervigenic agents like Vit B6, Vit B12, etc., the underlying cause needs to be treated.

So, kindly consult a Neurologist & get a proper clinical examination done, including nerve conduction studies.
Investigations like complete blood count, estimation of blood pressure & blood sugar levels will be helpful to rule out any pathological cause for the symptoms.

There is no need to worry, you will be fine.
Take care.
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Arm Pain, Numbness In Fingers. Chest X-ray Normal. Pinched Nerve?

Dear Michelle, First of all, please do not get concerned with the possibility of having a Pancoast tumor. As you had undergone 5 X rays & all of them reveal normal findings. The symptoms as mentioned in your post can be attributed to: 1. Neuropathy or nerve compression- as suspected by your doctor. 2. Dietary deficiency of certain nutrients like Iron, Vit B6, Vit B12, Folic acid, etc. which help in blood formation and nerve conduction. 3.Systemic causes like diabetes or hypertension 4. Hypocalcemia- decrease in calcium levels in the body 5. Metabolic & Hormonal causes Though symptomatic relief can be obtained by administration of nervigenic agents like Vit B6, Vit B12, etc., the underlying cause needs to be treated. So, kindly consult a Neurologist & get a proper clinical examination done, including nerve conduction studies. Investigations like complete blood count, estimation of blood pressure & blood sugar levels will be helpful to rule out any pathological cause for the symptoms. There is no need to worry, you will be fine. Take care.