Introduction Due to inflammation at crossing point of 1st dorsal compartment (APL and EPB ) and 2nd dorsal compartment (ECRL, ECRB) Epidemiology common in rowers weight lifters Pathophysiology mechanism is repetitive wrist extension Anatomy Extensor tendon compartments Compartment 1 (De Quervain's Tenosynovitis ) APL EPB Compartment 2 (Intersection syndrome) ECRL ECRB Compartment 3 EPL Compartment 4 EIP EDC Compartment 5 (Vaughn-Jackson Syndrome ) EDM Compartment 6 (Snapping ECU ) ECU Presentation Symptoms pain over dorsal forearm and wrist Physical exam tenderness on dorsoradial forearm approximately 5cm proximal to the wrist joint provocative tests crepitus over area with resisted wrist extension and thumb extension Imaging Radiographs not required for the diagnosis or treatment of intersection syndrome MRI indications to confirm diagnosis when clinical findings unclear views fluid sensitive sequences (short tau inversion recovery, STIR; fat suppressed proton density, FS PD; T2-weighted) findings most characteristic is peritendinous edema or fluid surrounding the 1st and 2nd extensor compartments other findings - tendinosis, muscle edema, tendon thickening, loss of the normal comma shape of the tendon, and juxtacortical edema may also be seen Treatment Nonoperative rest, wrist splinting, steroid injections indications first line of treatment technique injection aimed into 2nd dorsal compartment (ECRL, ECRB) Operative surgical debridement and release indications rarely indicated in recalcitrant cases technique release of the 2nd dorsal compartment approximately 6 cm proximal to radial styloid
QUESTIONS 1 of 2 1 2 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ07.235) A collegiate rower complains of dorsal wrist pain for 6 weeks refractory to NSAIDs and bracing. Maximal tenderness is palpated on the dorsoradial forearm approximately 5 cm proximal to the wrist. Pain is exacerbated with resisted wrist extension. Radiographs are unremarkable. A steroid injection should be directed into the compartment containing which of the following structures? Review Topic QID: 896 1 APL and EPB tendons 13% (341/2662) 2 ECRL and ECRB tendons 75% (1986/2662) 3 EPL tendon 3% (81/2662) 4 APL and ECRB tendons 8% (216/2662) 5 Brachoradialis tendon 1% (25/2662) ML 2 Select Answer to see Preferred Response PREFERRED RESPONSE 2