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Radial nerve: compression in the elbow. Radial tunnel syndrome

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Written by Garotta Lorenzo   

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Often a "tennis elbow" which does not heal with all available treatments can be hiding other diseases more difficult to diagnose (for example osteoid osteoma of the radial head ...). 

Radial tunnel syndrome results from compression of the radial nerve (posterior interosseous) in its passage at the Frohse arcade in the elbow. This syndrome may be associated with epicondylitis in 5% of cases. Both diseases can be treated during the same operation. Pain from a radicular origin is however different from the classic epicondylitis pain: clinical examination is very important to make the diagnosis.

Symptoms. 
The classic symptomatic pain is localized lower down compared with the epicondyle: pain may be associated with a forced supination (for example - shaking hands ...)

Diagnosis 
Diagnosis of radial tunnel syndrome is based on clinical examination: three signs of neuropathy will be sought. 1) pain on direct palpation over the arcade of Frohse, below the epicondyle, 2) active supination with elbow flexion induces the same pain, 3) an injection of local anesthetic relieves the pain. 

Electromyography

Electromyography (EMG) is useful, but sometimes difficult to interpret. MRI can show nerve compression by some neoplasm (cysts...) otherwise difficult to see with a standard x-ray.   


Medical and surgical
If the diagnosis is confirmed, surgery can be performed with good results. The surgical technique includes the release of the radial nerve through the Frohse’s arcade.

Rehabilitation and Physiotherapy

Rehabilitation of elbow surgery is crucial to get a good result and is performed according to protocols well codified. The goal is to start early rehabilitation to prevent stiffness and muscle atrophy.

(This website only provides a general guidance: it is essential that you strictly follow the advise given by the surgeon and physiotherapist who are providing the treatment.)

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Last Updated on Sunday, 07 February 2010 22:00