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Review Question - QID 7793

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QID 7793 (Type "7793" in App Search)
A 22-year-old man reports a 2-week history of a burning pain along the dorsoradial aspect of the distal forearm. The pain radiates to the dorsum of the thumb. Examination reveals tenderness and reproduction of symptoms with percussion 8 cm proximal to the radial styloid. Reproduction of symptoms also occurs with forearm pronation and ulnar deviation of the wrist. No discrete sensory deficit is noted and electrodiagnostic studies are normal. Nonsurgical management consisting of rest, splinting, and anti-inflammatory medications for 6 weeks has failed to provide relief. Treatment should now consist of decompression of the

lateral antebrachial cutaneous nerve in the interval between the abductor pollicis longus and the extensor pollicis brevis in the forearm.

3%

26/768

lateral antebrachial cutaneous nerve in the interval between the brachioradialis and the extensor carpi radialis longus in the distal forearm.

6%

45/768

radial sensory nerve in the interval between the extensor carpi radialis longus and the extensor carpi radialis brevis in the distal forearm.

12%

95/768

radial sensory nerve in the interval between the brachioradialis and the extensor carpi radialis longus in the distal forearm.

64%

494/768

radial sensory nerve in the interval between the brachioradialis and the extensor carpi radialis brevis in the distal forearm.

13%

99/768

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Wartenberg's syndrome, or compression of the sensory branch of the radial nerve, occurs in the interval between the brachioradialis and the extensor carpi radialis longus approximately 8 cm proximal to the radial styloid. There may be history of repetitive wrist/forearm circumduction activity (ie, knitting) or of wearing a tight wristwatch or jewelry. It can occur in patients who have been handcuffed. Typical clinical findings are pain, paresthesia, and/or hypesthesia in the dorsoradial aspect of the wrist and hand in the distribution of the radial sensory nerve. There is often a positive Tinel's sign over the compression site. Hypesthesia may be present in the distribution of the radial sensory nerve which is typically on the dorsal aspect of the first dorsal web space and dorsum of the thumb; however, with overlap in the distribution of the superficial radial nerve and the lateral cutaneous nerve of the forearm this may not always be present. Surgical management consists of release of the nerve as it exits the interval between the brachioradialis and the extensor carpi radialis longus in the distal forearm.

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