Radial Tunnel Syndrome - Posterior Interosseous Nerve Compression Syndrome

Abstract

Radial tunnel syndrome (RTS) and posterior interosseous nerve (PIN) compression syndrome are pathologic conditions that are believed to have the same etiology. Τhe former is characterized by chronic elbow and forearm pain radiating to the wrist and dorsum of the hand and fingers, whereas the latter should be considered when weakness or palsy of muscles innervated by the PIN is present. Both pathologic conditions are attributed to compression of the radial nerve in the anatomic space between the radial head and the inferior border of the supinator muscle, also described as the radial tunnel. Compression can occur in various sites within that space. Thorough clinical examination is of paramount importance to diagnose both syndromes. Electrodiagnostic tests and imaging techniques are also available and may be helpful to pinpoint possible causes of radial nerve compression. In cases of radial tunnel syndrome, where no motor dysfunction is present, a period of conservative treatment is justifiable with many potential therapeutic modalities such as rest, anti-inflammatory medication, injections at site and physiotherapy. Persisting symptomatology, identifiable cause of nerve compression or existing motor deficiency are indications for surgical decompression of the radial tunnel and release of the PIN. Surgical decompression can be performed via various approaches of the forearm and even endoscopic techniques may be utilized.