Wrist

Intersection Syndrome

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Intersection Syndrome, Cross-over Tendinitis, Tenosynovitis of the Radial Wrist Extensors, Extensor Tenosynovitis of Wrist

  • See Also
  1. Overuse Syndromes of the Hand and Wrist
  • Risk Factors
  1. Occupational
    1. Sledgehammer use
  2. Sports
    1. Racquet sports
    2. Rowing (Oarsman Syndrome)
    3. Weight Training
  • Pathophysiology
  1. Tenosynovitis of the Radial Wrist Extensors triggered by repetitive, resisted wrist extension
  2. Inflammation at intersection of compartment 1 and 2
  3. Dorsal Compartment 1 Tendons
    1. Abductor Pollicis longus
    2. Extensor Pollicis Brevis
  4. Dorsal Compartment 2 Tendons
    1. Extensor Carpi Radialis Longus
    2. Extensor Carpi Radialis Brevis
  • Symptoms
  1. Crepitus (or "squeaking") and pain at dorsal wrist, provoked with wrist or hand movement
  • Signs
  1. Focal symptoms at dorsolateral wrist at base of thumb
    1. Localized at 4 to 8 cm proximal to lister's tubercle of distal radius
  2. Local, palpable swelling and possible redness
  3. Local discomfort with radiation into thumb
  • Differential Diagnosis
  1. De Quervain's Tenosynovitis
  • Management
  1. Conservative Management
    1. Rest and activity modification
    2. Thumb Spica Splint (e.g. Thumb Keeper Pre-fabricated splint)
    3. Cold Therapy
    4. Physical therapy, occupational therapy or hand therapy
  2. Measures in refractory cases
    1. Intersection Syndrome Steroid Injection
    2. Consider surgical management in refractory cases
  • References
  1. Chatterjee (2016) BMJ Case Rep +PMID: 27681354 [PubMed]
  2. Pujalte (2024) Am Fam Physician 110(4): 402-10 [PubMed]