Intersection Syndrome

(Tenosynovitis of radial wrist extensor)



Background

Location of Intersection Syndrome symptoms
  • A painful condition that affects distal forearm on dorsoradial aspect,where two muscles crossover or intersect two underlying tendons
  • Localised pain exacerbated by repetitive wrist flexion and extension.
  • Caused (A) Direct trauma or (B) repetitive flexion and extension of wrist
  • Particularly affects weight lifters, rowers and construction workers etc..
  • On examination
    • Discrete tender swelling at the site of pain
    • Active and passive motion of wrist = “wet leather’ crepitus

Differential diagnosis

  • de Quervain's tenosynovitis
  • Arthritis involving thumb MPJ
  • EPL tendonitis
  • Radial sensory nerve irritation

Investigations

  • XR of Wrist and distal forearm
  • MRI only if there is suspicion of soft tissue mass

Treatment

  • Immobilisation, using wrist splint,20 degree extension X 3 weeks
  • Activity modification at home or work
  • NSAID for 7 to 10 days
  • Steroids injection
  • Physiotherapy
  • Sever cases,immobilise in forearm POP for 2wks

Content by Mr Syed Ali Naqi 23/05/2007. Last reviewed ÍOS 16/12/19