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Bicyclists Beware

Hugh H. Hussey, MD
JAMA. 1975;231(7):738. doi:10.1001/jama.1975.03240190042017.
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In a forthcoming issue of Archives of Neurology, Eckman et al1 describe three patients in whom ulnar neuropathy resulted from prolonged bicycle riding with consequent compression of the ulnar nerve at the wrist. The authors report one case in detail as follows:

A 22-year-old student had ridden a bicycle across the United States, covering approximately 3,000 miles in 30 days. On or about the tenth day of the trip he noted the onset of weakness in both hands, not associated with any sensory disturbance. There was no associated pain in the neck or arms.

The notable findings on examination were limited to the hands. There was bilateral weakness and atrophy of the dorsal interossei, the abductor digiti minimi, and the adductor pollicis muscles. The flexor carpi ulnaris muscles were normal bilaterally. Detailed sensory testing in the hands showed no deficits. The tendon reflexes in the upper extremities were equal


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