The referring internist ordered complete blood count, kidney and liver functions studies, and rheumatologic lab studies. All test results were normal. The pain is constant. He denies fever or chills, or any bowel or bladder problems. Coughing, sneezing or bowel movements do not exacerbate or reproduce his pain.
Mental function is normal.
Cranial nerve examination is normal. Sensory examination revealed no focal abnormal findings of the upper limbs, with mildly decreased vibratory sensation at both toes compared to the ankles and knees. Cerebellar function is normal and his gait is normal. He feels decreased pinprick sensation on the left lateral chest wall, mid-abdominal area, and lower thoracic area on the left side. He has entirely normal sensory function on the right side.