Hand Conditions

Intersection Syndrome

Definition:

Tenosynovitis (inflammation) of tendons (extensor carpi radialis brevis and extensor carpi radialis longus) and synovial membranes located on the thumb side in the second dorsal compartment of the wrist.

Symptoms:

  • Pain and swelling on the thumb side about 4-6 cm up from the wrist joint on the dorsal (back) aspect of the wrist.
  • Often found in activities that involve repetitive wrist extension.
  • The sensation of “footprints on freshly packed snow” is the hallmark for palpating (touching) the area.

Pathology:

  • Likely entrapment and friction of the second dorsal compartment tendons with the first compartment tendons.
  • Tenosynovitis were the two sets of tendons intersect.

Treatment:

Non-surgical

  • Rest, activity modifications, removable wrist splint, ice and NSAID’s (ibuprofen)
  • Occupational Therapy
  • Corticosteroid injection

Surgical

  • Indicated when non-operative treatment fails.
  • The extensor retinaculum covering the synovial membrane and tendons is incised (released).