Intersection syndrome

Intersection syndrome is an overuse injury of the forearm.

Pain is located approximately 2 finger breaths (4cm) proximal to the wrist joint.

• Pathology occurs at the “intersection” of the 1^st (APL and EPB) and 2^nd (ECRL and ECRB) dorsal compartments.
• Friction occurs at the muscle bellies of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB), where they cross over the extensor carpi radialis longus (ECRL) and brevis (ECRB)

https://www.sportsmedreview.com/wp-content/uploads/2020/11/intersectionsyndrome.png

Mechanism: friction is caused by repetitive wrist extension activities

Commonly: Rowing, skiing, tennis, canoeing and weightlifting 

Friction may cause crepitus with finger/wrist extension.

Tenderness, mild swelling may be present

• Intersection syndrome is often confused with de Quervain’s tendinopathy. 

 

• Key distinguishing features:
  • Location of the pain: Intersection syndrome is more dorsal while de Quervain’s is more radial
  • https://www.reumatologiaclinica.org/en-distal-intersection-syndrome-an-unusual-articulo-S2173574319300656#imagen-2
  • Exacerbating maneuvers: Pronation/extension vs ulnar wrist deviation
  • Noise: Crepitus with wrist extension