Paresthesias • Xray of the Week 2016 • Week #42

This 60 year old caucasian male with stage 4 fibrosis of liver presented with unsteady gait and falls. He also had paresthesias including tingling and numbness of the wrists for one month.

Laboratory values as follows:

MMA = 24,600 (N 0-0.40 nmol/mL...