Alter Todd H, Romeo Paul V, Bielicka Deidre L, Monica James T
Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Hospital, New Brunswick, USA.
Cureus. 2023 Mar 30;15(3):e36919. doi: 10.7759/cureus.36919. eCollection 2023 Mar.
Distal intersection syndrome (DIS) is a rare form of tenosynovitis affecting the second and third dorsal extensor compartments of the wrist, which is rarer and more distal than the classically described intersection syndrome between the first and second compartments. In this report, we present three cases of DIS, their inciting activities, and ensuing treatment courses. Diagnosis of DIS was confirmed via MRI in all cases. Treatment modalities consisted of non-steroidal anti-inflammatory medications and varying durations of immobilization in all three patients, initially. One patient ultimately underwent surgical debridement and partial tenosynovectomy. At the end of follow-up, all patients saw a reduction in symptomatology with a return to baseline activity levels. This case report provides an overview of the possible clinical courses of DIS, as well as treatment strategies that can be implemented. Providers must maintain a high index of suspicion for this condition and treat patients with a great deal of caution, as extensor tendon rupture is possible.
远侧交叉综合征(DIS)是一种罕见的腱鞘炎形式,影响手腕的第二和第三背侧伸肌间隔,比经典描述的第一和第二间隔之间的交叉综合征更罕见且位置更靠远侧。在本报告中,我们呈现了3例DIS病例、其诱发活动及后续治疗过程。所有病例均通过磁共振成像(MRI)确诊为DIS。最初,所有3例患者的治疗方式包括使用非甾体类抗炎药物以及不同时长的固定。1例患者最终接受了手术清创和部分腱鞘切除术。在随访结束时,所有患者的症状均有所减轻,并恢复到基线活动水平。本病例报告概述了DIS可能的临床病程以及可实施的治疗策略。医疗服务提供者必须对这种疾病保持高度的怀疑指数,并极其谨慎地治疗患者,因为存在伸肌腱断裂的可能。