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Orthopaedics · Hand disorders: intersection syndrome
Sample itemA rower has pain, swelling and crepitus on the dorsoradial forearm about 5 cm proximal to the wrist, where tendons cross. Finkelstein test is negative. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Intersection syndrome
Intersection syndrome is inflammation where the first dorsal compartment tendons, abductor pollicis longus and extensor pollicis brevis, cross over the wrist extensors about 4 to 8 cm proximal to the wrist. It causes proximal pain and crepitus with repetitive wrist motion, as in rowing. De Quervain disease causes pain at the radial styloid with a positive Finkelstein test.
Option by option
A. Intersection syndrome (correct)
Correct. Proximal dorsoradial crepitus with a negative Finkelstein test indicates intersection syndrome.
B. De Quervain tenosynovitis
De Quervain disease localises to the radial styloid with a positive Finkelstein test.
C. Kienbock disease
Kienbock disease causes central dorsal wrist pain.
D. Scaphoid fracture
A scaphoid fracture causes snuffbox tenderness after a fall.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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