A 72-year-old man presented with a 3-month history of worsening neck and right arm pain radiating down the inner forearm, associated with numbness and tingling involving the index and middle fingers.
Examination of the right upper limb revealed reduced forearm pronation and wrist flexion, decreased sensation in the index and middle fingers, and diminished triceps tendon reflex.
What is the most likely site of the lesion?
A: axillary nerve
B: C6 root
C: C7 root
D: median nerve
E: radial nerve
Correct answer: C Explanation The description of symptoms and distribution of pain is consistent with a root rather than a single nerve lesion. Reduced wrist flexion (median and ulnar nerves, C6–T1), diminished triceps tendon reflex (C7) and diminished sensation in index and middle fingers (C6, C7) localises the lesion to C7 root.