Intersection syndrome

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What is intersection syndrome?

Intersection syndrome – also called tenosynovitis of the radial wrist extensors – is a form of wrist tendonitis. It is associated with inflammation of the tendons in the wrist and back of the forearm and causes pain around the back of the wrist joint. It occurs at the point at which the two major tendons that are used to move the fingers cross.

What causes intersection syndrome?

The condition is caused by repetitive movements that stress the wrist extensor tendons. It is most common in athletes, particularly competitive rowers and weightlifters, and can also affect office workers or anyone who carries out repetitive wrist and arm movements. It is sometimes confused with the more common De Quervain’s syndrome.

What are the symptoms of intersection syndrome?

Symptoms include:

  • Pain and swelling of the tendons in the wrist and back of the forearm
  • A grinding sensation when the fingers are moved

How is intersection syndrome diagnosed?

If a diagnosis cannot be made by a physical examination alone, an injection of local anaesthetic into the affected area can confirm whether the pain is coming from the wrist extensor tendons. If the anaesthetic brings relief at the point where these two tendons intersect, a diagnosis of intersection syndrome will be confirmed.

How is intersection syndrome treated?

Initially, the affected tendons need rest so you should not use your wrist for a few days until the inflammation subsides. You may need to wear a wrist brace during this time to keep the wrist immobilised, ideally with the joint splinted at around 15 degrees. Ice can be used to reduce swelling and anti-inflammatories can help to relieve symptoms. Cortisone injections into the tendons may help to relieve pain and inflammation. In some cases you may need debridement surgery to release any abnormally tight tissue from around the tendons in order to relieve pain and prevent recurrence.