Skip to Main Content

++

CONDITION/DISORDER SYNONYM

++

  • Radial nerve palsy

++

ICD-9-CM CODE

++

  • 354.3 Radial nerve lesion

++

ICD-10-CM CODES

++

  • G56.31 Lesion of radial nerve, right upper limb

  • G56.32 Lesion of radial nerve, left upper limb

++

PREFERRED PRACTICE PATTERNS

++

  • 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation1

  • 5F: Impaired Peripheral Nerve Integrity and Muscle Performance Associated with Peripheral Nerve Injury2

++

PATIENT PRESENTATION

Patient is a 25-year-old female administrative assistant. She spends a significant amount of time utilizing the computer keyboard. She is reporting a burning pain in her dorsal forearm throughout the day depending on how much typing she has done. The pain is exacerbated by flexing her wrist down, typing, and lifting file folders in pronation. She denies any numbness/tingling into her distal extremity and only reports the local forearm pain. Functionally, she has to take frequent rest breaks throughout the day and when she becomes symptomatic her typing rate decreases as well. She is woken at night approximately 5 days per week especially when her hand drops off the edge of the bed into wrist flexion.

Clinically, she does not present with any sensory deficits. She does have a 10 lb grip strength decrease and reports pain with testing. Palpable tenderness in extensor mass 5 cm distal to lateral epicondyle. Increased symptoms with passive wrist flexion/ulnar deviation/elbow extension combination as well as resisted long finger extension and forearm supination. Positive neurodynamic testing with radial nerve bias.

++

KEY FEATURES

++
Description
++

  • Entrapment neuropathy of the radial nerve, particularly the posterior interosseous nerve (PIN) or dorsal radial sensory nerve (DRSN) in the elbow and wrist

    • DRSN compression is synonymous with Wartenberg’s syndrome

  • Common entrapment sites include3:

    • Thickened fascial tissue superficial to radiocapitellar joint

    • Fibrous origin of extensor carpi radialis brevis (ECRB)

    • Radial recurrent vessels-leash of Henry

    • Proximal border of supinator-arcade of Frohse

    • Distal edge of supinator

    • Between tendons of brachioradialis and extensor carpi radialis longus (DRSN)

    • Subcutaneous tissue in distal forearm (DRSN)

  • Signs and symptoms typical of neuropathy, includes:

    • Pain

    • Paresthesias

    • Loss of sensation

    • Later loss of muscle function

  • Symptoms are seen in the distribution of the radial nerve in the hand3, dorsal distal upper arm and dorsal forearm 4 to 5 cm distal to the lateral epicondyle

++
Essentials of Diagnosis
++

  • Burning or aching pain, paresthesias, and sensory loss perceived on dorsum of the forearm, thumb, and digits I–III dorsally; sensory changes only if DRSN syndrome

  • Rest pain and night pain are common3,4

++
General Considerations
++

  • In entrapment neuropathy, nerve becomes compressed, causing ischemic damage to the nerve.

  • Often associated with repetitive motions or sustained position of the elbow.

  • Unrelieved compression of the nerve results in ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.