A 65-year-old man is evaluated for slowly progressive, right-h | Surgery collections Videos and quizez 2021

A 65-year-old man is evaluated for slowly progressive, right-hand clumsiness for several months. Medical history is significant for hypertension and end-stage renal disease, for which he undergoes hemodialysis 3 times a week. The patient is retired and not physically active. He does not use tobacco, alcohol, or illicit drugs. Blood pressure is 130/90 mm Hg and pulse is 80/min. BMI is 20 kg/m2. Examination shows decreased sensation over the 4th and 5th fingers of the right hand and a weaker grip compared to the left side. Overall muscle mass and tone are decreased in all four extremities.