A 22-year-old art student with arm numbness/tingling that worsens with overhead reaching; based on symptoms, the patient should be evaluated for?

Prepare for the Individual Readiness Assurance Test (iRAT) 4 in Head and Neck. Study with multiple-choice questions, comprehensive explanations, and detailed flashcards. Maximize your chances of success with thorough preparation and insightful study resources.

Overhead arm activity causing numbness and tingling points to thoracic outlet syndrome, where the brachial plexus (and sometimes the subclavian vessels) can be compressed as the shoulder girdle is elevated or stressed. In a young person who uses the arm in overhead positions, this compression is common and produces symptoms in the arm and hand that worsen with elevation and improve when the arm is lowered.

Cervical radiculopathy would more often involve neck pain and a dermatomal pattern related to a cervical nerve root, not specifically tied to overhead reaching. Carpal tunnel syndrome involves median nerve symptoms in the hand, typically at night or with wrist use, not mainly driven by overhead activity. Ulnar neuropathy affects the ring and little fingers and is tied to elbow or wrist positioning rather than overhead elevation.

So, the presentation is most consistent with thoracic outlet syndrome and should be evaluated accordingly.