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Traditionally, ``knapsack palsy'' refers to a weakness of the serratus anterior muscle secondary to injury of the long thoracic nerve [1] consequent to carrying a heavy knapsack for a prolonged period. We recently encountered a patient who developed a compression neuropathy of the posterior interosseous nerve ascribable to carrying a heavy knapsack over one arm. The importance of distinguishing a posterior interosseous nerve palsy from a radial nerve palsy and the unusual cause in this case prompted this report.
Case report
A previously well, 28-year-old, left-handed law student noted weakness of her left hand one evening. The weakness was unassociated with paresthesiae or numbness and, apart from a mild aching in her left forearm, was painless. In the week before onset, she had been carrying a knapsack laden with heavy law textbooks in her left hand twice daily, for approximately 25 minutes at a time, as she walked to and from campus. The knapsack was supported …
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