Intersection Syndrome

What is Intersection Syndrome?
Intersection syndrome involves the inflammation of tendons that extend the wrist.  It tends to occur where these tendons cross with tendons that help to extend the thumb.  Each time the wrist is extended, these tendons move and rub against one another.  Inflammation of the tendons within their respective compartments at this crossing point occurs during repetitive wrist extension activities, commonly seen in weightlifting, rowing, golf, and racquet sports.

Symptoms:

The main symptom is pain over the top portion of the wrist and forearm especially with wrist extension and gripping activities.  The area of pain is also usually tender to palpation, and often has a unique rubbing/creaking sensation called crepitus.

 

Diagnostic Testing:

X-rays are normally ordered to rule out things such as fracture, bone spurs, and arthritis.  An MRI may also be ordered to rule out other findings, especially when the diagnosis is unclear.

 

Treatment:

Rest and wrist splinting typically calms down the inflammation associated with Intersection Syndrome and is the first line treatment.  Physical Therapy will usually be recommended to try to help decrease the inflammatory process.  Dr. Steven Lee may also recommend NSAID’s such as Advil or Aleve, or administer a steroid injection into the affected area to further help decrease inflammation and pain (if not contraindicated). 

 

Surgical Treatment:

Surgery is rarely indicated yet may be necessary in cases unresponsive to rest, splinting, and injections.  Surgery involves making a small incision on top of the wrist and releasing (i.e. opening up) one of the compartments containing the inflamed tendons, and cleaning out the inflamed tissue (tenosynovectomy). 

 

Learn about scheduling surgery.

 

Recovery Expectations

Patients are usually immobilized in a wrist splint for 2-3 weeks status post surgery.  Physical therapy is usually started at the 3 week mark and patients are allowed to start weaning use of their splint.  Patients can expect to return to normal activity approximately 4-6 weeks after surgery.

Immediate Post-Operative Instructions

Please refer to the following pages for more information:

 

*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

 

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.  

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