Physical examination maneuver
Physical Exam
Sharp Sensation
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With the patient's eyes closed, touch the skin with a clean sharp object (a disposable neurological pin or a freshly broken wooden applicator), interspersing dull touches, and ask the patient to report 'sharp' or 'dull.' Compare sides and regions.
How to Interpret
Showing 3 of 8 findings
Carpal Tunnel Syndrome
Hypalgesia (reduced pinprick sensation in the median nerve distribution)
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Moderate
Lumbosacral Radiculopathy
Sensory loss in the S1 distribution
Rule in
Not helpful
Rule out
Not helpful
Evidence:Moderate
Peripheral Neuropathy
Decreased or absent sharp (pin-prick) sensation in a stocking-glove distribution
Rule in
HelpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate
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Rule out:VHPeripheral Neuropathy, MHHypothyroidism, NHLumbosacral Radiculopathy +5 more
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Light Touch Sensation
Rule in:VHCervical Radiculopathy, VHPeripheral Neuropathy, SHLumbosacral Radiculopathy +6 more
Rule out:MHPeripheral Neuropathy, NHCauda Equina Syndrome, NHCervical Radiculopathy +6 more
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Rule in:VHLumbosacral Radiculopathy, VHPeripheral Neuropathy, IECerebellar Disease +5 more
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Rule in:VHStroke, HFalls, HVascular Parkinsonism +24 more
Rule out:SHDementia, SHVascular Parkinsonism, MHFalls +24 more
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Vibratory Sensation
Rule in:VHPeripheral Neuropathy, ICCarpal Tunnel Syndrome
Rule out:VHPeripheral Neuropathy, NHCarpal Tunnel Syndrome