Posterior interosseous neuropathy: Difference between revisions
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==Background== | ==Background== | ||
[[File:Nerves of the left upper extremity.gif|thumb|Nerves of the left upper extremity.]] | |||
*Posterior interosseous nerve (C7-8) is a branch of the radial nerve that supplies motor innervation to the forearm extensor muscles | *Posterior interosseous nerve (C7-8) is a branch of the radial nerve that supplies motor innervation to the forearm extensor muscles | ||
*Compression or injury can cause an isolated PIN palsy <ref>Dang AC et al. Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. JHS. 2009;34A:1906-1914.</ref> | *Compression or injury can cause an isolated PIN palsy <ref>Dang AC et al. Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. JHS. 2009;34A:1906-1914.</ref> | ||
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*More common in body builders and laborers due to repetitive pronosupination | *More common in body builders and laborers due to repetitive pronosupination | ||
== | ===Causes=== | ||
*Peripheral neuropathy | *Peripheral neuropathy | ||
**Repetitive microtrauma | **Repetitive microtrauma | ||
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***[[Forearm fracture]] | ***[[Forearm fracture]] | ||
**Space occupying lesions | **Space occupying lesions | ||
***Ganglion cyst | ***[[Ganglion cyst]] | ||
***Lipoma | ***Lipoma | ||
***Bone tumor | ***Bone tumor | ||
*Iatrogenic | *Iatrogenic | ||
== | ==Clinical Features== | ||
[[File:Cutaneous innervation of the upper limb.svg|thumb|Cutaneous innervation of the upper limb]] | |||
*Forearm and wrist pain | |||
* | *Weakness on finger and wrist extension | ||
* | |||
==== | ==Differential Diagnosis== | ||
{{Upper extremity peripheral nerve syndromes}} | |||
==Evaluation== | ==Evaluation== | ||
===Workup=== | |||
*Plain films | *Plain films | ||
*EMG | *EMG (as outpatient) | ||
===Diagnosis=== | |||
*Usually a clinical diagnosis (in ED) | |||
==Management== | ==Management== | ||
*Nonoperative: rest, activity modification, NSAIDs, splinting | *Nonoperative: rest, activity modification, [[NSAIDs]], [[splinting]] | ||
*Operative decompression: compressive masses | *Operative decompression: compressive masses | ||
Latest revision as of 14:42, 5 February 2022
Background
- Posterior interosseous nerve (C7-8) is a branch of the radial nerve that supplies motor innervation to the forearm extensor muscles
- Compression or injury can cause an isolated PIN palsy [1]
- More proximal pathologies can cause a combined palsy
- More common in body builders and laborers due to repetitive pronosupination
Causes
- Peripheral neuropathy
- Repetitive microtrauma
- Entrapment
- Trauma
- Space occupying lesions
- Ganglion cyst
- Lipoma
- Bone tumor
- Iatrogenic
Clinical Features
- Forearm and wrist pain
- Weakness on finger and wrist extension
Differential Diagnosis
Upper extremity peripheral nerve syndromes
Median Nerve Syndromes
Ulnar Nerve Syndromes
Radial Nerve Syndromes
- Radial neuropathy at the spiral groove (ie. "Saturday night palsy")
- Posterior interosseous neuropathy
Proximal Neuropathies
- Suprascapular neuropathy
- Long thoracic neuropathy
- Axillary neuropathy
- Spinal accessory neuropathy
- Musculocutaneous neuropathy
Other
Evaluation
Workup
- Plain films
- EMG (as outpatient)
Diagnosis
- Usually a clinical diagnosis (in ED)
Management
- Nonoperative: rest, activity modification, NSAIDs, splinting
- Operative decompression: compressive masses
Disposition
- Discharge with orthopedic follow up
See Also
External Links
References
- ↑ Dang AC et al. Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. JHS. 2009;34A:1906-1914.