Proximal intersection syndrome

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Electrician with forearm pain and swelling.

Patient Data

Age: 35 years
Gender: Male

Skin marker placed over the site of pain and swelling. Soft tissue swelling and edema with fluid in the tendon sheath at the point of APL and EPB crossing or intersecting with the ECRL and ECRB tendons.

Case Discussion

Proximal intersection syndrome is a painful "friction" condition that affects the thumb side of the forearm when inflammation occurs at the intersection of the musculotendinous junctions of the abductor pollicis longus and extensor pollicis brevis as they cross over the extensor carpi radialis longus and the extensor carpi radialis brevis tendons. The mechanism of injury is usually repetitive resisted extension, as with rowing, weight lifting, or pulling. Proximal intersection syndrome is often confused with De Quervain's tenosynovitis that occurs more distally at the wrist rather than the forearm.

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