Intersection Syndrome
(Tenosynovitis of radial wrist extensor)
- 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
