Peripheral nerves (thickened)

Thickened peripheral nerves should be palpated for if there is evidence of a peripheral nerve lesion, peripheral neuropathy, or a mononeuritis complex. The most accessible points are:

• median nerve at the wrist
• ulnar nerve at the elbow
• common peroneal nerve at the head of the fibula

Causes of thickening may be remembered by the mnemonic HAGALO:

• Hypertrophic neuropathy - a rare autosomal dominant condition
• Acromegaly
• Guillain Barre - if relapsing and remitting disease
• Amyloid
• Leprosy
• Others - e.g. neurofibromatosis, diabetes, sarcoidosis, Charcot-Marie-Tooth disease