![]() ![]() ![]() Non-surgical treatment of radial tunnel syndrome includes rest, NSAID, therapy with modalities, work modification, ergonomic modification, injection if associated with lateral epicondylitis. Radiographic evaluation of the elbow should be performed to rule out other diagnoses. Also, the disease can be diagnosed by a positive "middle finger test", where resisted middle finger extension produces pain. Tenderness to palpation occurs over the area of the radial neck. The chief complaint of this disease is usually pain in the dorsal aspect of the upper forearm, and any weakness described is secondary to the pain. This syndrome may be clinically tested by flexing the patients long finger while the patient extends the wrist and fingers. The diagnosis is based on symptoms and signs alone and objective testing is expected to be normal. This problem is often caused by: bone tumors, injury (specifically fractures of the forearm), noncancerous fatty tumors (lipomas), and inflammation of surrounding tissue. Unlike carpal tunnel syndrome, radial tunnel syndrome does not present tingling or numbness, since the posterior interosseous nerve mainly affects motor function. Therefore, it is extremely important in upper body extremity movement and can cause significant pain to patients presenting with radial tunnel syndrome. It provides motor function through innervation to most extensor muscles of the posterior arm and forearm. The nerve also provides sensory branches that travel to the periosteum of the lateral epicondyle, the anterior radiohumeral joint, and the annular ligament. The radial nerve provides sensation to the skin of posterior arm, posterior and lateral forearm and wrist, and the joints of the elbow, wrist and hand. a fracture that puts pressure on the radial nerve). The radial nerve is commonly compressed within a 5 cm region near the elbow, but it can be compressed anywhere along the forearm if the syndrome is caused by injury (e.g. Some scientists believe the radial tunnel extends as far as the distal border of the supinator. The "radial tunnel" is the region from the humeroradial joint past the proximal origin of the supinator muscle. The term "radial tunnel syndrome" is used for compression of the posterior interosseous nerve, a division of the radial nerve, at the lateral intermuscular septum of arm, while "supinator syndrome" is used for compression at the arcade of Frohse. Some speculate that radial tunnel syndrome is a type of repetitive strain injury (RSI), but there is no detectable pathophysiology and even the existence of this disorder is questioned. The theory is that the radial nerve becomes irritated and/or inflamed from friction caused by compression by muscles in the forearm. The pain is often reproduced upon resisted supination of the forearm, and pain at the radial tunnel on resisted hyperextension of the wrist. ![]() Patients may typically have weakness of extension at the wrist and third digit. The diagnosis is confirmed by diagnostic nerve block and surgical decompression is an effective form of treatment.Radial tunnel syndrome causes posterolateral elbow pain that is similar to tennis elbow and may sometimes occur in conjunction with that condition. ![]() Recently a fifth site has been identified: a fascial arcade is often present lining the deep surface of the superficial head of the supinator muscle and this band can exert pressure on the posterior interosseous branch of the radial nerve just before it emerges from beneath that muscle. The fourth, and most common site, is at the arcade of Fröhse. The third potential site of compression occurs at the tendinous margin of the extensor carpi radialis brevis muscle. The second site occurs at the radial recurrent vessels, lying across the radial nerve. The first is by fibrous bands lying anterior to the radial head at the entrance to the tunnel. There are four potential sites of compression within the radial tunnel. Radial tunnel syndrome is an entrapment neuropathy of the radial nerve as it passes through the radial tunnel, from the level of the head of the radius to the distal edge of the supinator muscle. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |