Intersection syndrome - Revision history

ClaireLewis at 16:30, 18 October 2019

2019-10-18T16:30:21Z

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	==Management==		==Management==
	===Nonoperative===		===Nonoperative===
	* Thumb ~~Spica Splint~~ - to reduce thumb and wrist extension and radial deviation <ref>Tobin, A. L. (2017). “Ice Axe Wrist”: A Case Report of Intersection Syndrome in 2 Climbers. Wilderness & Environmental Medicine, 28(3), 230-233. doi:10.1016/j.wem.2017.03.016</ref>		* [[Thumb spica]] splint - to reduce thumb and wrist extension and radial deviation <ref>Tobin, A. L. (2017). “Ice Axe Wrist”: A Case Report of Intersection Syndrome in 2 Climbers. Wilderness & Environmental Medicine, 28(3), 230-233. doi:10.1016/j.wem.2017.03.016</ref>
	* Compression - to reduce swelling		* Compression - to reduce swelling
	* Ice		* Ice
	* Depending on severity, may consider steroid injection to 2nd dorsal compartment (ECRL, ECRB)		* Depending on severity, may consider [[steroid]] injection to 2nd dorsal compartment (ECRL, ECRB)

	===Operative===		===Operative===

Rossdonaldson1: /* References */

2019-05-10T01:31:11Z

References

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	[[Category:Orthopedics]]		[[Category:Orthopedics]]
			[[Category:Sports Medicine]]

Jnmerica: /* Background */

2018-04-24T20:54:06Z

Background

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	==Background==		==Background==
	*Extensor wrist tenosynovitis		*Extensor wrist tenosynovitis
	*~~Second compartment~~ of dorsal wrist containing extensor carpi radialis brevis and longus (ECRB and ECRL)		*Caused by overuse of wrist and hand
	*~~Overuse of wrist~~ and ~~hand~~		*Located at the intersection of the first and second dorsal compartments of wrist containing extensor carpi radialis brevis and longus (ECRB and ECRL). Has also been called “Oarsman’s Wrist,” “Bugaboo Forearm,” “Peritendinitis Crepitans,” “Crossover Syndrome,” and “Squeaker’s Wrist.”<ref>Tobin, A. L. (2017). “Ice Axe Wrist”: A Case Report of Intersection Syndrome in 2 Climbers. Wilderness & Environmental Medicine, 28(3), 230-233. doi:10.1016/j.wem.2017.03.016</ref> "Intersection Syndrome" more aptly describes the anatomy involved as this is an inflammatory condition occuring where the abductor pollicis longus and extensor pollicis brevis tendons cross the extensor carpiradialis brevis and extensor carpi radialis longus tendons in the forearm.
			*Relatively uncommon, but has been seen in rowing, baseball, softball, hockey, cycling, golf, skiing, ice climbing and racquet sports
	[[File:Extensor compartments of wrist.JPG\|thumbnail\|extensor compartments of wrist]]		[[File:Extensor compartments of wrist.JPG\|thumbnail\|extensor compartments of wrist]]

	==Clinical Features==		==Clinical Features==
	*~~Pain~~ where ECRL and ECRB intersect with abductor pollicis longus (APL), extensor pollicis brevis (EPB)		*Unilateral pain where ECRL and ECRB intersect with abductor pollicis longus (APL), extensor pollicis brevis (EPB) - over the dorsum of the wrist on the radial side of the dominant hand, about 5 cm proximal to wrist joint
			*Swelling
			*Crepitus may be present on active and passive wrist flexion, extension, radial, and ulnar deviation
			*Neurovascular evaluation should be normal, and there is usually no associated pain or restriction is proximal joints (elbow, shoulder, neck)
	*Easily confused with [[De Quervain tenosynovitis]]		*Easily confused with [[De Quervain tenosynovitis]]

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	==Evaluation==		==Evaluation==
			*Finkelstein’s Test may be positive, but the area of tenderness should be further proximal from the wrist, oppose to over the first compartment as is seen in DeQuervain tenosynovitis.<ref>Tobin, A. L. (2017). “Ice Axe Wrist”: A Case Report of Intersection Syndrome in 2 Climbers. Wilderness & Environmental Medicine, 28(3), 230-233. doi:10.1016/j.wem.2017.03.016</ref>
			* Radiographs are not necessary for diagnosis
			* MRI may be considered for diagnosis if clinical findings are unclear, will likely show peritendinous edema or fluid surrounding the 1st and 2nd extensor compartments. May also see tendinosis, muscle edema, tendon thickening, loss of the normal comma shape of the tendon, and juxtacortical edema.

	==Management==		==Management==
			===Nonoperative===
			* Thumb Spica Splint - to reduce thumb and wrist extension and radial deviation <ref>Tobin, A. L. (2017). “Ice Axe Wrist”: A Case Report of Intersection Syndrome in 2 Climbers. Wilderness & Environmental Medicine, 28(3), 230-233. doi:10.1016/j.wem.2017.03.016</ref>
			* Compression - to reduce swelling
			* Ice
			* Depending on severity, may consider steroid injection to 2nd dorsal compartment (ECRL, ECRB)

			===Operative===
			* Rarely used, may consider surgical debridement and release of the second dorsal compartment approximately 6 cm proximal to the radial styloid if the condition becomes severe and chronic

	==Disposition==		==Disposition==
			*Conservative
			*One case report of two ice axe climbers found that creating a thumb spica split using zinc oxide tape, in combination with icing, was sufficient to reduce symptoms within days, in both a climber who continued to climb and one who rested <ref>Tobin, A. L. (2017). “Ice Axe Wrist”: A Case Report of Intersection Syndrome in 2 Climbers. Wilderness & Environmental Medicine, 28(3), 230-233. doi:10.1016/j.wem.2017.03.016</ref>

	==See Also==		==See Also==

Rossdonaldson1: /* Disposition= */

2018-03-29T20:12:11Z

Disposition=

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	=Disposition==		==Disposition==

Rossdonaldson1: /* Differential Diagnosis */

2018-03-29T20:02:01Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Hand and finger injury DDX}}

	==Evaluation==		==Evaluation==

Mholtz at 05:42, 4 July 2017

2017-07-04T05:42:38Z

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	*Pain where ECRL and ECRB intersect with abductor pollicis longus (APL), extensor pollicis brevis (EPB)		*Pain where ECRL and ECRB intersect with abductor pollicis longus (APL), extensor pollicis brevis (EPB)
	*Easily confused with [[De Quervain tenosynovitis]]		*Easily confused with [[De Quervain tenosynovitis]]

			==Differential Diagnosis==


			==Evaluation==


			==Management==


			=Disposition==


	==See Also==		==See Also==
	*[[~~Radiograph-Negative~~ Hand and ~~Finger Injuries~~]]		*[[Hand and finger diagnoses]]

			==External Links==
	*See Dr. Nabil Ebraheim's video on [https://www.youtube.com/watch?v=ZKGB2sFaJzA dorsal wrist compartment syndromes]		*See Dr. Nabil Ebraheim's video on [https://www.youtube.com/watch?v=ZKGB2sFaJzA dorsal wrist compartment syndromes]

Neil.m.young: Text replacement - "==Sources==" to "==References=="

2016-06-26T06:44:50Z

Text replacement - "==Sources==" to "==References=="

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	*See Dr. Nabil Ebraheim's video on [https://www.youtube.com/watch?v=ZKGB2sFaJzA dorsal wrist compartment syndromes]		*See Dr. Nabil Ebraheim's video on [https://www.youtube.com/watch?v=ZKGB2sFaJzA dorsal wrist compartment syndromes]

	==~~Sources~~==		==References==
	<references/>		<references/>

	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Kxl328 at 23:17, 29 May 2016

2016-05-29T23:17:25Z

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	*Extensor wrist tenosynovitis		*Extensor wrist tenosynovitis
	*Second compartment of dorsal wrist containing extensor carpi radialis brevis and longus (ECRB and ECRL)		*Second compartment of dorsal wrist containing extensor carpi radialis brevis and longus (ECRB and ECRL)
			*Overuse of wrist and hand
	[[File:Extensor compartments of wrist.JPG\|thumbnail\|extensor compartments of wrist]]		[[File:Extensor compartments of wrist.JPG\|thumbnail\|extensor compartments of wrist]]

Kxl328 at 23:16, 29 May 2016

2016-05-29T23:16:55Z

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	==Clinical Features==		==Clinical Features==
			*Pain where ECRL and ECRB intersect with abductor pollicis longus (APL), extensor pollicis brevis (EPB)
			*Easily confused with [[De Quervain tenosynovitis]]

	==See Also==		==See Also==

Kxl328 at 23:14, 29 May 2016

2016-05-29T23:14:53Z

← Revisión anterior		Revisión del 23:14 29 may 2016
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	==Clinical Features==		==Clinical Features==

			==See Also==
			*[[Radiograph-Negative Hand and Finger Injuries]]
			*See Dr. Nabil Ebraheim's video on [https://www.youtube.com/watch?v=ZKGB2sFaJzA dorsal wrist compartment syndromes]

	==Sources==		==Sources==