(See also Overview and Evaluation of Hand Disorders Overview and Evaluation of Hand Disorders Common hand disorders include a variety of deformities, ganglia, infections, Kienböck disease, nerve compression syndromes, noninfectious tenosynovitis, and osteoarthritis. (See also complex... read more .)
Compression at the elbow can result from trauma, ganglia Ganglia Ganglia are cystic swellings occurring usually on the hands, especially on the dorsal aspect of the wrists. Aspiration or excision is indicated for symptomatic ganglia. (See also Overview and... read more , lipomas Lipomas Lipomas are soft, movable, subcutaneous nodules of adipocytes (fat cells); overlying skin appears normal. This photo shows a lipoma on the extremity. Lipomas are very common, benign, and usually... read more , bone tumors Benign Bone Tumors and Cysts Benign bone tumors include benign giant cell tumors of bone, chondroblastomas, chondromyxoid fibromas, enchondromas, nonossifying fibromas, osteoblastomas, osteochondromas, and osteoid osteomas... read more , or radiocapitellar (elbow) synovitis.
Symptoms and Signs of Radial Tunnel Syndrome
Symptoms of radial tunnel syndrome include lancinating pain in the dorsum of the forearm and lateral elbow. Pain is precipitated by attempted extension of the wrist and fingers and forearm supination. Sensory loss is rare because the radial nerve is principally a motor nerve at this level. This disorder is sometimes confused with backhand tennis elbow (lateral epicondylitis Lateral Epicondylitis Lateral epicondylitis results from inflammation and microtearing of fibers in the extensor tendons of the forearm. Symptoms include pain at the lateral epicondyle of the elbow, which can radiate... read more ). When weakness of the extensor muscles is the primary finding, the condition is referred to as posterior interosseus nerve palsy.
Diagnosis of Radial Tunnel Syndrome
Lateral epicondylitis can cause similar tenderness around the lateral epicondyle but does not cause the Tinel sign (paresthesia elicited by percussion over a nerve) or tenderness along the course of the radial nerve (which travels under the mobile wad group of muscles in the proximal radial forearm).
Treatment of Radial Tunnel Syndrome
Splinting allows avoidance of the forceful or repeated motion of supination or wrist dorsiflexion, reducing pressure on the nerve.
If wristdrop or weakened digital extension develops, or conservative treatment fails to provide relief after 3 months, surgical decompression may be needed.