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50 yrs male Complaints of gradual weakness and muscle wasting of both upper limbs Expert opinion please doctors

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Small muscle atrophy of both hands DD Syringomyelia, MND, diabetic peripheral neuropathy, Myopathy

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Needs more history and physical findings for meaningful discussion.Weak muscles should be examined at rest.1st picture dorsal view fingers are stretched,the tendons are more prominent with clawing of left little finger.Hand is not in the resting position .Look for faciculations in the resting position.Other pictures shows severe wasting of the thenar muscles. This pt need good history and physical exam ,Refer to Neurologist.

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Bilateral dystrophy or westing of musles in hypothinner area of hands Ie lowermotorneuron lesion somewhere c5c6c7 And needs to investigate Palpate ulner nerves bilaterally are the thickened think of nerve atrophy Possible d/d leprosy Tuberculosis

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LGMD (Proximal muscular dystrophy Limb Girdle) But first investigate as Dr.Ramesh kumar Singh advised and Muscle biopsy

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Small muscle atrophy of both hands DD Syringomyelia, MND, diabetic peripheral neuropathy, Myopathy

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Neurosurgeon or neurologist opinion for ALS @Dr. Yashesh Dalal Sir

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Sir, i think complete Neurologicalphysical examination is very important

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Shoulder girdle muscular hypertrophic dystrophy

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Agree With Dr Shivraj Sir

Thanku Dr S M
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Dear please ask for CBC ESR Blood SUGAR LFT RFT RE URINE T3T4TSH chest X-RAY PA view Anaemia PROFILE VITAMIN DEFICIENCY then we can come on DIAGNOSIS

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If no sensory loss, amyotrophic lateral sclerosis is a possible diagnosis.do EMG to confirm.MRI of cervical spine should also be done.

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