Summary Radial Tunnel Syndrome is a compressive neuropathy of the posterior interosseous nerve (PIN) at the level of proximal forearm (radial tunnel). Diagnosis is made clinically with pain only (maximal tenderness 3-5 cm distal to lateral epicondyle) without any motor or sensory dysfunction. Treatment is a prolonged course of conservative management with NSAIDs, temporary splinting and CSIs with radial tunnel decompression reserved for refractory cases. Epidemeology Incidence rare login to view 1 more bullet Demographics male > females Etiology Pathophysiology involves same sites of compression as PIN syndrome include (from proximal to distal) login to view 8 more bullets risks login to view 1 more bullet Associated conditions lateral epicondylitis login to view 1 more bullet Anatomy Radial Tunnel 5 cm in length from the level of the radiocapitellar joint, extending distally past the proximal edge of the supinator boundaries login to view 9 more bullets PIN origin login to view 1 more bullet course login to view 4 more bullets innervation login to view 16 more bullets Presentation Symptoms deep aching pain in dorsoradial proximal forearm login to view 2 more bullets muscle weakness login to view 1 more bullet Physical exam tenderness login to view 3 more bullets provocative tests login to view 9 more bullets sensory login to view 2 more bullets motor login to view 1 more bullet Imaging MRI usually negative indications login to view 6 more bullets Studies Electrodiagnostic studies EMG/NCV are inconclusive because login to view 4 more bullets Diagnostic injection injection of local anesthetic (LA) into the area of localized tenderness ensure that LA does not spread to lateral epicondyle Differential Key differential Lateral epicondylitis login to view 3 more bullets Cervical radiculopathy at C6-7 login to view 1 more bullet Diagnosis Clinical diagnosis is made with careful history and physical examination Treatment Nonoperative activity modification, temporary splinting, NSAIDS login to view 4 more bullets corticosteroid injection login to view 5 more bullets Operative radial tunnel release login to view 10 more bullets Techniques Radial tunnel release approach login to view 7 more bullets technique login to view 3 more bullets outcomes login to view 1 more bullet