Intersection Syndrome

Aka: Intersection Syndrome, Cross-over Tendinitis, Tenosynovitis of the Radial Wrist Extensors, Extensor Tenosynovitis of Wrist

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II. Causes

  1. Occupational
    1. Sledgehammer use
  2. Sports
    1. Racquet sports
    2. Rowing (Oarsman Syndrome)
    3. Weight Training

III. Pathophysiology

  1. Tenosynovitis of the Radial Wrist Extensors
  2. Inflammation at intersection of compartment 1 and 2
  3. Dorsal Compartment 1 Tendons
    1. Abductor Pollicis longus
    2. Extensor Pollicis Brevis
  4. Dorsal Compartment 2 Tendons
    1. Extensor Carpi Radialis Longus
    2. Extensor Carpi Radialis Brevis

IV. Symptoms

  1. Crepitus with wrist or hand movement
  2. Focal symptoms at dorsolateral wrist at base of thumb
    1. Local swelling and redness
    2. Local discomfort with radiation into thumb

V. Differential Diagnosis

  1. De Quervain's Tenosynovitis

VI. Management

  1. Rest
  2. Splinting
  3. Cold Therapy
  4. Consider surgical management in refractory cases

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