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Erschienen in: Current Reviews in Musculoskeletal Medicine 3/2021

23.04.2021 | Compressive Neuropathies in the Upper Extremity (E Shin, Section Editor)

Radial Tunnel Syndrome

verfasst von: Yelena Levina, Phani K. Dantuluri

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 3/2021

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Abstract

Purpose

Radial tunnel syndrome is defined as a compressive neuropathy of the posterior interosseus nerve. It is differentiated from posterior interosseus nerve compression by symptom profile. The purpose of this article is to review past and current literature on the topic and determine if there are any emerging treatment options for this condition.

Recent Findings

Traditionally, conservative management of Radial Tunnel syndrome has been relatively unsuccessful. As a result, patients afflicted by this neuropathy require operative intervention. Effectiveness of surgical decompression is variable and can range from 67 to 92% but currently remains the standard treatment. However, there are some conservative treatment options that have been recently reported that show promising results. Such treatments include dry needling of the affected area and ultrasound guided corticosteroid injections to hydro dissect around the posterior interosseus nerve at sites of compression.

Summary

Radial tunnel syndrome is an uncommon and unique peripheral neuropathy. It involves the posterior interosseus nerve however it can be differentiated from PIN syndrome based on the symptom profile. There are various compressive etiologies that can cause a patient to become symptomatic; therefore it is important to critically assess the patient and their symptoms and use appropriate imaging to determine the cause and appropriate treatment. Typically, conservative treatments are attempted first. Traditionally, conservative therapy is unsuccessful and operative decompression is necessary. However, current literature highlights various new nonsurgical options that suggest some promise and could be alternatives to surgical decompression.
Literatur
14.
18.
Zurück zum Zitat • Marchese J, Coyle K, Cote M, Wolf JM. Prospective Evaluation of a Single Corticosteroid Injection in Radial Tunnel Syndrome. HAND. 2018;155894471878728. https://doi.org/10.1177/1558944718787282. This is a notable reference, as it describes a viable alternative treatment to surgical intervention for radial tunnel syndrome. This is a prospective study of improved quality that shows a clinical important difference in qDASH scores after an injection after a year of follow up. This study demonstrates that a single corticosteroid injection is a viable option to attempt prior to choosing operative intervention. • Marchese J, Coyle K, Cote M, Wolf JM. Prospective Evaluation of a Single Corticosteroid Injection in Radial Tunnel Syndrome. HAND. 2018;155894471878728. https://​doi.​org/​10.​1177/​1558944718787282​. This is a notable reference, as it describes a viable alternative treatment to surgical intervention for radial tunnel syndrome. This is a prospective study of improved quality that shows a clinical important difference in qDASH scores after an injection after a year of follow up. This study demonstrates that a single corticosteroid injection is a viable option to attempt prior to choosing operative intervention.
19.
Zurück zum Zitat • Anandkumar S. Effect of dry needling on radial tunnel syndrome: A case report. Physiotherapy Theory and Practice. 2019;35(4):1–10. https://doi.org/10.1080/09593985.2018.1443357. This is a notable reference from the previous three years as it describes a non-surgical method of treating radial tunnel syndrome. While most literature shows conservative intervention is often unsuccessful in treating radial tunnel syndrome, in the last several years that have been reports of success such as this one that show that there are treatment options less invasive then surgical decompression. While the data is not strong, if patient’s would like to try more conservative measures this case report provides another options.CrossRef • Anandkumar S. Effect of dry needling on radial tunnel syndrome: A case report. Physiotherapy Theory and Practice. 2019;35(4):1–10. https://​doi.​org/​10.​1080/​09593985.​2018.​1443357. This is a notable reference from the previous three years as it describes a non-surgical method of treating radial tunnel syndrome. While most literature shows conservative intervention is often unsuccessful in treating radial tunnel syndrome, in the last several years that have been reports of success such as this one that show that there are treatment options less invasive then surgical decompression. While the data is not strong, if patient’s would like to try more conservative measures this case report provides another options.CrossRef
20.
Zurück zum Zitat • Garcia N, Rosales J, Greene C, Droppelmann G, Verdugo MA. Ultrasound guided hydraulic release associated with corticosteroids in radial tunnel syndrome: description of technique and preliminary clinical results. J Ultrasound Med. 2019;00:1–4. https://doi.org/10.1002/jum.15085. This is an important reference, as it describes a viable alternative treatment to surgical intervention for radial tunnel syndrome. While injections have been used in the past, this study used ultrasound guided injections that helped to better localize the pathologic structures. While there is no long term outcomes from this study, it shows that such a treatment could be used with the guidance of ultrasound for improved results prior before moving on to more invasive treatments such as surgical release.CrossRef • Garcia N, Rosales J, Greene C, Droppelmann G, Verdugo MA. Ultrasound guided hydraulic release associated with corticosteroids in radial tunnel syndrome: description of technique and preliminary clinical results. J Ultrasound Med. 2019;00:1–4. https://​doi.​org/​10.​1002/​jum.​15085. This is an important reference, as it describes a viable alternative treatment to surgical intervention for radial tunnel syndrome. While injections have been used in the past, this study used ultrasound guided injections that helped to better localize the pathologic structures. While there is no long term outcomes from this study, it shows that such a treatment could be used with the guidance of ultrasound for improved results prior before moving on to more invasive treatments such as surgical release.CrossRef
Metadaten
Titel
Radial Tunnel Syndrome
verfasst von
Yelena Levina
Phani K. Dantuluri
Publikationsdatum
23.04.2021
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 3/2021
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-021-09703-w

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