Thanks for your interest and reply Bob. I see her next week and will seek her permission to take photos. Must admit I did not pay much attention to her upper limbs--bit overwhelmed by below knee stuff. Did test her reflexes. KJ (L) and (R) hyper with no damping, AJs very hard to elicit. The objective was limited to what described previously because I felt she was not tolerating it too well. Am endeavouring to track her GP down for more info. Trying to arrange podiatry appointment to address the issues of support for the foot. I think her next appointment is eary next week so I will get back to you. Regards Ben