Distal intersection syndrome

Case contributed by Dr Yasser Asiri

Presentation

Wrist pain.

Patient Data

Age: 65 years
Gender: Female
MRI

There is soft tissue edema around thearea of crossing of extensor pollicis longus (EPL) over the the second extensor compartment (extensor carbi radialis brevis (ECRB) and extensor carpi radialis longus (ECRL). There is fluid signal intensity within the synovial sheath of ECRB, the second and third extensor tendon compartments in keeping with tenosynovitis with mild interstitial tear of the ECRL and EPL tendons.

Cystic changes of the carpal bones. Unremarkable flexor tendons.  Normal appearance of the median nerve. Normal appearance and signal intensity of the triangular fibrocartilage. No joint effusion present. 

The overall imaging feature is compatible with distal intersection syndrome. 

Case Discussion

Intersection syndrome is a result of repetitivestress or trauma resulting in tenosynovitis and peritendinous edema in the extensor tendons compartments, two types have been described, the proximal type and distal type. This case shows the typical features of distal intersection syndrome where the third extensor compartment tendon (the extensor pollicis longus) crosses over the extensor carpi radialis longus and brevis tendons. 

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Case information

rID: 65509
Published: 16th Jan 2019
Last edited: 29th Dec 2020
Inclusion in quiz mode: Included