Radial Nerve Entrapment

Question 1

What is the cause of a radial nerve entrapment?

Answer 1

Overuse/ repetitive stress or trauma

Question 2

T/F: Radial nerve entrapments are rare conditions.

Answer 2

True

Question 3

There are 3 main locations for a radial nerve entrapment, what are they?

Answer 3

• Radial Tunnel Syndrome
• Posterior Interosseous Nerve Compression Syndrome (PINS)
• Wartenberg Syndrome

Question 4

What are radial nerve entrapments often confused with?

Answer 4

Lateral elbow teninopathies but they present different

Question 5

T/F: Radial Tunnel nerve entrapments only have symptoms, no signs.

Answer 5

True

Question 6

What is the course of the radial nerve?

Answer 6

Brachial Plexus –> Posterior Cord –> Passes Inferior to Teres Major –> Passes Posterior to the Brachial Artery in the Posterior Arm –> Travels just Anterior to the Lateral Epicondyle Before Entering the Posterior Forearm

Question 7

What is “radial tunnel syndrome”?

Answer 7

Neuropathy involving the posterior interosseous nerve (PIN) branch

Question 8

With radial tunnel syndrome what is the site and where is the patient TTP?

Answer 8

• 2-5 cm distal to lateral epicondyle (this is the primary finding)
• Between distal edge of supinator and around the radial neck posteriorly

Question 9

What are the symptoms of radial tunnel syndrome?

Answer 9

• Dorsoradial proximal forearm pain and possibly paresthesias into dorsal thumb and web space
• Provoked by supination/ pronation and elbow flexion

Question 10

T/F: There is no motor or sensory deficit with radial tunnel syndrome.

Answer 10

True

Question 11

What is “Posterior Interosseous Nerve Compression Syndrome”?

Answer 11

More severe radial tunnel syndrome with same symptoms plus sensory and motor dysfunction

Question 12

Patients with posterior interosseous nerve compression syndrome have decreased sensation where?

Answer 12

Over the dorsoradial forearm and dorsal thumb and web space

Question 13

Patients with posterior interosseous nerve compression syndrome have what motions that are weak and painful?

Answer 13

Wrist and finger extension

Question 14

Patients with posterior interosseous nerve compression syndrome have what positive dural mobility?

Answer 14

(+) Radial nerve dural mobility

Question 15

Patients with posterior interosseous nerve compression syndrome have what positive special tests?

Answer 15

(+) resisted supination test

Question 16

What is Wartenberg Syndrome?

Answer 16

• Neuropathy
• Compression of superficial sensory radial nerve between Brachioradialis and ECRL

Question 17

Does wartenberg syndrome have motor innervation?

Answer 17

No motor innervation so no weakness

Question 18

What kind of symptoms are present with wartenberg syndrome?

Answer 18

Only sensory symptoms or paresthesias and pain over the dorsoradial forearm and dorsal aspect of the 1st 3 and a half digits

Question 19

For terminal nerve branch injuries what is your Rx?

Answer 19

• POLI (No C) ED: when compression is the cause
• Bracing/ Splinting
• Neural mobilizations if an adhesion
• MET with optimal stresses to create neural motion/ flossing and the above elimination of compression