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Anterior interosseous syndrome is a medical condition in which damage to the anterior interosseous nerve (AIN), a distal motor and sensory branch of the median nerve, classically with severe weakness of the pincer movement of the thumb and index finger, and can cause transient pain in the wrist (the terminal, sensory branch of the AIN innervates the bones of the carpal tunnel).
Symptoms are pain and tenderness at the radial side of the wrist, fullness or thickening over the thumb side of the wrist, painful radial abduction of the thumb, and difficulty gripping with the affected side of the hand. [2] Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm. [2]
Finkelstein's test was described by Harry Finkelstein (1865–1939), an American surgeon, in 1930. [5]A similar test was previously described by Eichhoff, in which the thumb is placed in the palm of the hand and held with the fingers, and the hand is then ulnar deviated (see images), causing intense pain over the radial styloid which disappears if the thumb is released.
An illustration of wrist pain. Wrist pain or open wrist is a syndrome inhibiting use of a hand due to pain in anatomical structures of the wrist. [1] It most commonly results from an injury to a ligament. [1] The pain may be sharp from a traumatic injury or from chronic repetitive wrist activities. [1]
Any movement of the thumb and wrist causes the patient pain, inflammation and swelling. The presence of anomalous or variant muscles in the fourth compartment may result in chronic dorsal wrist pain, a condition known as the fourth compartment syndrome. [4] Intersection syndrome can be caused by direct trauma to the second extensor compartment.
The examiner passively restricts the flexion of the fingers while the examinee attempts to actively flex the thumb. [10] A positive test is marked by restricted active thumb flexion with pain or cramping discomfort in the palmar and radial sides of the distal (lower) forearm or wrist. [10]
6.7 to 9.7 centimetres (2.6 to 3.8 in) in length, the tendon passes through a long and superficial synovial sheath which, passing obliquely from the radial border of the forearm into the thumb, extends from the proximal border of the extensor retinaculum to the first carpometacarpal joint.
The supinator and the anconeus are the two extensor muscles in the posterior compartment of the forearm that do not pass through wrist extensor compartments. [3] The first compartment locating the most radial is occupied by the extensor pollicis brevis and the abductor pollicis longus to insert to the thumb.