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Journal of Korean Neurosurgical Society 1998;27(9): 1266-1270.
Radial Tunnel Syndrome: Case Report.
Byung Kil Son, Jang Chul Lee, Chang Young Lee, Eun Ik Son, Dong Won Kim, Man Bin Yim, In Hong Kim, Sung Moon Lee
1Department of Neurosurgery, School of Medicine, Keimyung University, Taegu, Korea.
2Department of Diagnostic Radiology, School of Medicine, Keimyung University, Taegu, Korea.
Radial tunnel syndrome is a rare disorder and it's symptoms sometimes so closely overlap those lateral epicondylitis, causing difficulties to differentiate. A 39-year-old man was presented who had a 2.5-year history of right elbow and forearm pain which was unseccesfully treated as 'tennis elbow'. Clinically, severe tender point over the forearm was relieved after a local anesthetic injection. Axial STIR(short tau inversion recovery) image showed high signal intensity at the origin of the extensor carpi radialis brevis, which was so minimal that it was not comparable to clinical symptoms. But radial nerve was revealed normal. So we decided that the symptoms were caused not by lateral epicondylitis but rather by radial tunnel sybdrome and an operation was performed. In the operative field, the most proximal part of the superficial head of the supinator muscle was tendinous and formed a fibrous arch, which was resected. After the operation, the right arm pain was relieved. This is a case diagnosed as lateral epicondylitis which showed no improvement under conservative treatment, but improved after a local anesthetic injection on the tender point. When a case with no correlations between lateral epicondylitis degree in MRI and clinical symptoms, one should take the possibility of radial tunnel syndrome into consideration.
Key Words: MRI; Radial tunnel syndrome; Lateral epicondylitis; Posterior interosseous nerve
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