Intersection Syndrome

Intersection syndrome is characterized by swelling of thumb side of the arm causing intense pain. Swelling occurs at the point of intersection where the muscles blend with thumb finger. It can cause tensynovitis (inflammation (swelling) of fluid filled sheath that envelops a tendon of the wrist. The junction of the first extensor tendons and the second extensor tendons develop inflammation due to repeated friction. Since this involves swelling of intersection of extensor tendons, the name Intersection syndrome is given.

This can occur when the person makes consistent movement of the wrist like typing. This syndrome can cause pain and swelling of the thumb region causing difficulty in making movement. The symptoms can be managed by applying creams to control inflammation and by giving complete rest to the affected tendons.

Symptoms :

Intersection syndrome is marked by pain and swelling of tendons of the wrist. It becomes difficult to move the fingers due to inflammation. It can affect the routine activities of the person since he may find it difficult to move his forearm. The pain may get worse if the person moves his forearm repeatedly.

Causes :

Synovial fluid gets collected in the joints causing swelling of synovial membrane. The tissues of the synovial joint can be compressed due to the swelling of second extensor portion. The condition of tenosynovitis can be caused due to repetitive movements of the forearm which is particularly more for jobs involving typing and rowing etc.

People with chronic arthritis condition are more likely to develop Intersection syndrome. Wartenberg syndrome or radial sensory irritation of the nerve, thumb arthritis and de Quervain tenosynovitis (irritation of the upper tendons of the wrist) can cause this syndrome. Even APL syndrome and adventitial bursitis can lead to inflammation of tendons of the thumb region. Weightlifters, horseback riders and racket players are more prone to develop this problem than others.

Diagnosis :

The doctor can physically examine the affected forearm to check for swelling of synovial membrane. Ultrasound scan of the forearm is usually made to confirm the diagnosis. MRI test is conducted to get a clear picture of the extensor compartments.

Treatment :

Firstly the affected person should immobilize the affected forearm. Swelling will automatically resolve if there is no movement. Anti-inflammatory drugs can be taken to manage the inflammation. Corticosteroid pills are effective to give relief from pain and swelling. Your doctor may give a shot of this injection in the affected area.

Wrist splint can be used for not making any movement of the forearm. Until the inflammation is completely resolved, the splint must be used. It can take 3-4 weeks of application of wrist splint, depending on the case. The person can gradually remove the splint and do stretching exercises slowly returning to normal movement. Surgery is done if inflammation is severe and it does not respond to any other treatment. The patient must follow the instructions of the surgeon to keep the forearm immobilized.

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