Examining the Forearm Intersection through Palpation and Ultrasonography

Author:

Naredo Esperanza1,Murillo-González Jorge2ORCID,Mérida Velasco José2,Olivas Vergara Otto1,Kalish Robert3ORCID,Gómez-Moreno Cristina4,García-Carpintero Blas Eva4,Fuensalida-Novo Gema4,Canoso Juan35

Affiliation:

1. Department of Rheumatology and Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Diaz, IIS Fundación Jiménez Díaz, Autónoma University, 28049 Madrid, Spain

2. Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain

3. Division of Rheumatology, Tufts University School of Medicine, Boston, MA 02111, USA

4. Department of Nursing, Hospital Universitario Fundación Jiménez Díaz, 28049 Madrid, Spain

5. Department of Medicine, Emeritus, ABC Medical Center, Mexico City 01120, Mexico

Abstract

Background: Forearm intersection syndrome causes pain, swelling, and a rub at the dorsal distal forearm where the first extensor compartment muscles intersect with the second compartment tendons. Although primary care settings tend to treat mild cases, high-performance athletes may suffer from severe symptoms that require surgery. This proof-of-concept study aims to help detect the anatomical substrate of forearm intersection syndrome using palpation and ultrasonography when available. Methods: Five individuals were studied using independent palpation and ultrasonography to identify the first dorsal compartment muscles and the second dorsal compartment tendons. The distances between the dorsal (Lister’s) tubercle of the radius and the ulnar and radial edges of the first dorsal compartment muscles were measured to determine the location and extent of the muscle–tendon intersection. The palpatory and ultrasonographic measurements were compared using descriptive statistics and the paired t-test. Results: The mean distances from the dorsal tubercle of the radius to the ulnar and radial borders of the first dorsal compartment muscles were 4.0 cm (SE 0.42) and 7.7 cm (SE 0.56), respectively, based on palpation. By ultrasonography, the corresponding distances were 3.5 cm (SD 1.05, SE 0.47) and 7.0 cm (SD 1.41, SE 0.63). Both methods showed a similar overlap length. However, ultrasonography revealed a shorter distance between the dorsal tubercle of the radius and the ulnar border of the first compartment than palpation (p = 0.0249). Conclusions: Our findings indicate that a basic knowledge of anatomy should help health professionals diagnose forearm intersection syndrome through palpation and, if available, ultrasonography.

Funder

Instituto de Salud Carlos III

Publisher

MDPI AG

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5. Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers;Drew;J. Sci. Med. Sport,2016

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