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Compression Neuropathy
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Vijay A Malshikare, J Terrence Jose Jerome
Radial tunnel syndrome is a more controversial diagnosis relying mainly on the pain and tenderness over the proximal forearm (5 cm distal to the lateral epicondyle), there are certain conditions which mimic RTS. History evaluation, clinical examination and diagnostic tools help in differentiating them from RTS (Table 11B.2).
The Large Intestine (LI)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Radial nerve (C5-C8): Supplies all the muscles in the posterior compartment of the brachium. The radial nerve divides into superficial and deep branches near the elbow. The deep branch only supplies muscular and articular branches. The posterior interosseous nerve is a continuation of the deep branch. The superficial branch only supplies cutaneous nerves, providing sensation to the dorsum of the hand and the digits. The posterior cutaneous nerve of the forearm is a branch of the radial nerve that supplies the skin along the posterior aspect of the forearm to the wrist. The posterior antebrachial cutaneous nerve arises from the radial nerve to supply the skin along the lateral arm and posterior forearm and wrist. Radial nerve compression can produce motor impairments and pain.1 The signs and symptoms associated with radial tunnel syndrome can produce pain in the lateral elbow and antebrachium, producing symptoms that overlap with lateral epicondylitis. Posterior interosseous nerve compression may additionally cause weakness in the hand.
Orthopaedic Pain
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Radial nerve compression syndromes can affect either the superficial or the deep portion. The superficial portion is purely sensory and is rarely affected. The deep or posterior branch provides motor innervation to the extensor muscles of the forearm and sensation to the dorsum of the hand distal to the wrist. Agnew (1963) first described posterior interosseous nerve syndrome. This is also referred to as radial tunnel syndrome. In some cases it may be confused with tennis elbow or lateral epicondylitis. The most common source of compression is an anatomic variant, usually at the arcade of Frohse. Other causes include the vascular leash of Henry, fibrous bands from the supinator, radiocapitellar joint, or extensor carpi radialis brevis (ECRB); mass lesions such as synovitis or bursitis are also implicated. Radial tunnel syndrome can produce pain without muscle weakness as first described by Michele and Kreuger (1956). There are three described signs that differentiate radial tunnel syndrome from tennis elbow: (1) tenderness to palpation distal to the radial head not at the lateral epicondyle, (2) increased pain with forearm supination due to posterior radial nerve compression by the arcade of Frohse, and (3) increased pain with extension of the middle finger against resistance when the wrist and elbow are in extension (middle finger test). Electromyography can be helpful in distinguishing radial tunnel syndrome from cervical radiculopathy. Conservative trials of splints for elbow flexion with wrist extension, activity modification, NSAIDs, and local injection should be attempted before surgical decompression.
Erognomic education on housework for women with upper limb repetitive strain injury (RSI): a conceptual representation of therapists’ clinical reasoning
Published in Disability and Rehabilitation, 2018
Therma W. C. Cheung, Lindy Clemson, Kate O’ Loughlin, Russell Shuttleworth
Repetitive strain injury (RSI) refers to a soft tissue disorder either caused by the overloading of certain muscle groups from repetitive use or by maintaining constrained posture during activities [1]. Upper limb RSI simply refers to the condition’s location in the body. There are many alternative terms that describe the condition. These include: upper extremity musculoskeletal disorders (UEMSDs) [2], or work-related neck and upper limb musculoskeletal disorders (WRULDs) [3], or upper extremity disorders (UEDs) [4]. All refer to a similar cluster of conditions in the upper limbs. Twelve diagnostic groups are classified as upper limb work-related musculoskeletal disorders [5] under the Swedish National Institute for Working Life classification system, referred to as upper limb RSI within the context of this article. They include: radiating neck pain, rotator cuff syndrome, medial epicondylitis, lateral epicondylitis, ulna nerve entrapment in the cubital tunnel, radial tunnel syndrome, flexor and extensor tendinitis at the hand and fingers, De Quervain tenosynovitis, carpal tunnel syndrome, ulnar nerve entrapment in Guyon’s tunnel, Raynaaud’s phenomenon or peripheral neuropathy related to vibrations of the hand and arm, and osteoarthritis of the elbow, wrist, and fingers.
Effect of dry needling on radial tunnel syndrome: A case report
Published in Physiotherapy Theory and Practice, 2019
Nerve entrapments in the upper limb frequently occur at mechanical interfaces. Examples include the median nerve at the carpal tunnel and ulnar nerve at the cubital tunnel (Pratt, 2005). Entrapment of the radial nerve in the forearm was first described in 1956 as radial pronator syndrome (Michele and Krueger, 1956). Other nomenclatures used over time to describe this entrapment are posterior interosseous nerve (PIN) syndrome and radial tunnel syndrome (RTS) (Pecina, Krmpotic-Nemanic, and Markiewitz, 2001; Roles and Maudsley, 1972).