From the Guidelines
Intersection syndrome is characterized by specific physical exam findings, including pain, swelling, and crepitus about 4-6 cm proximal to the wrist on the radial side of the forearm, which can be diagnosed or confirmed with US evaluation as noted in the 2024 study by 1. The physical exam findings for intersection syndrome typically include:
- Pain and swelling in the area where the first extensor compartment tendons cross over the second extensor compartment tendons
- Crepitus, often described as a "squeaking" sensation, during wrist movements, particularly with flexion and extension
- Tenderness on palpation of the affected area
- Limited range of motion due to pain
- Positive Finkelstein's test, although this is more specific for de Quervain's tenosynovitis These findings are consistent with the underlying pathophysiology of tenosynovitis or peritendinitis at the crossing point of these tendon groups, usually resulting from repetitive wrist movements or overuse, as supported by the 2024 study by 1 and further emphasized by the diagnostic capabilities of MRI in tendon abnormalities, including intersection syndromes, as discussed in the study by 1.
From the Research
Physical Exam Findings for Intersection Syndrome
The provided studies do not explicitly describe the physical exam findings for intersection syndrome. However, the following information can be gathered:
- Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm 2.
- Differential diagnosis must be carefully made, especially from De Quervain tendonsynovitis 2, 3.
- Clinical examination provides the necessary information for diagnosis, although magnetic resonance imaging scans and ultrasonography may assist in diagnosis 2.
- The studies do not provide specific details on the physical exam findings for intersection syndrome, such as tenderness, swelling, or limited range of motion.
Diagnosis and Treatment
The diagnosis of intersection syndrome is based on clinical examination, and treatment consists mainly of:
- Rest
- Use of a thumb spica splint
- Analgetic and oral nonsteroidal anti-inflammatory drugs
- Progressive stretching and muscle strengthening after 2-3 weeks 2
- Corticosteroid injections adjacent to the site of injury may be useful if symptoms persist beyond this time 2
- Surgical intervention is warranted in refractory cases 2