Synthesis of evidence for the treatment of intersection syndrome

Abstract

Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm. Differential diagnosis must be carefully made, especially from De Quervain tendonsynovitis. Clinical examination provides with the necessary information for diagnosis, still magnetic resonance imaging scans and ultrasonography may assist in diagnosis. Treatment consists mainly of rest, use of a thumb spica splint, analgetic and oral nonsteroidal anti-inflammatory drugs and after 2-3 wk progressive stretching and muscle strengthening. Should symptoms persist beyond this time, corticosteroid injections adjacent to the site of injury may be useful. In refractory cases, surgical intervention is warranted.

Keywords: Intersection syndrome, Overuse injury, Wrist pain, Differential diagnosis, Treatment

Core tip: In this review, current aspects of clinical and imaging diagnosis, as well as therapeutic approach of intersection syndrome, are outlined. This overuse syndrome which may provokes significant wrist pain and disability, is associated with repetitive wrist flexion and extension and compressive forces applied to the wrist and is common in sports such as rowing, canoeing, skiing, weight lifting and racket sports. Conservative treatment is generally an efficient therapeutic approach and includes means such as rest, cryotherapy, immobilization through splinting, medication with non-steroid anti-inflammatory and corticoid drugs as well as individualized rehabilitation program incorporating progressive stretching and muscle strengthening exercises. Future research is proposed to select larger samples if possible and utilize the frank value of imaging studies such as magnetic resonance imaging scans or ultrasonography as well as optimal therapeutic strategies for every individual suffering from this syndrome.