Review Question - QID 6441

A 38-year-old man who works as an auto mechanic reports right wrist pain and intermittent paresthesias and numbness into the ulnar two digits of his hand. The pain symptoms begin after a day of particularly strenuous repetitive use of the right hand. He denies any color changes to the digits but does report a significant smoking history. Weakness of the interossei muscles are seen on manual testing. Both radial and ulnar pulses are palpable at the wrist. The patient states that sensation on the dorsum of his ring and little fingers is normal. Radiographs are shown in Figures 25a through 25c. What is the most likely diagnosis?