Anomalous Course of the Extensor Pollicis Longus

Rubin, Guy; Wolovelsky, Alejandro; Rinott, Micha; Rozen, Nimrod

doi:10.1097/sap.0b013e318209a744

Cited by 11 publications

(11 citation statements)

References 16 publications

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“…Anomalous course of the EPL passes through other compartment out of the 3rd compartment. Anomalous course of the EPL is known to be much rare than duplication, as much as 5 cases were reported previously [6]. In our case, the EPL passes wrist though the 3rd compartment, but it is out of the 3rd compartment at the carpal bone level and inserted on the radial side of the thumb as the 1st compartment.…”

Section: Discussionsupporting

confidence: 47%

Anomalous Course of the Extensor Pollicis Longus With Multiple Absences of Thumb Muscles

et al. 2013

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We report a rare case of a 10-year-old girl with anomalous course of extensor pollicis longus (EPL) muscle, which exists with absence of thenar muscles and muscles in the 1st extensor compartment. Her chief complaint was severe atrophy on the right thenar eminence. On physical examination, there was no obvious functional abnormality on her right thumb. On magnetic resonance imaging, we found that the abductor pollicis brevis, opponens pollicis, abductor pollicis longus, and extensor pollicis brevis muscles were absent. The tendon of the EPL muscle was found, but it had abnormal insertion on the radial side of the proximal phalanx, not on the distal phalanx. This variation was thought to have played a major role in compensating for impaired abduction of the thumb, which is usually accompanied by agenesis of major abductors of the thumb.

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Section: Discussionsupporting

confidence: 47%

Anomalous Course of the Extensor Pollicis Longus With Multiple Absences of Thumb Muscles

et al. 2013

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“…Indeed, a variant course of a single EPL tendon outside of the third compartment is extremely rare and only four reports [1,[4][5][6] were found in the English literature. These four reports mostly describe passage of the EPL radial to Lister's tubercle and within the first compartment.…”

Section: Discussionmentioning

confidence: 96%

“…For example, Abe et al [1] described two cases of single EPL tendon running radial to Lister's tubercle into the fist extensor compartment. Also, Rubin et al [5] reported a single EPL tendon in the first compartment with initial symptoms resembling intersection syndrome, but the condition was subsequently diagnosed as de Quervain's disease. These two sets of authors report the absence of the snuff box and the absence of typical EPL skin contours due to EPL anomaly.…”

Section: Discussionmentioning

confidence: 97%

Variant course of extensor pollicis longus tendon in the second wrist extensor compartment

2015

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Among the muscles involved in thumb movement, the extensor pollicis longus (EPL) tendon of the hand is considered the most consistent structure with the least variation among individuals. There have been a few reports regarding different types of supernumerary tendons; however, an abnormal course of the EPL tendon is extremely rare. We describe a case of a variant course of a single EPL tendon appearing in the second extensor compartment of the wrist. This case was observed incidentally during wrist surgery, and demonstrates a unique variation of tendon course, which has not been reported previously. The knowledge of this anatomic variation is helpful in surgical planning and for making accurate diagnoses.

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“…To date only 5 cases of anomalous course of EPL tendon in symptomatic patients have been reported in the English literature. [ 6 – 8 , 12 ] Nishijo et al [ 6 ] described duplicated EPL passing radial to Lister's tubercle into the first dorsal compartment and in her left hand, ulnar to Lister's tubercle in a normal course. Sawaizumi et al [ 12 ] also described the anomalous course of duplicated EPL tendon, one of them in a new compartment.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 , 4 , 5 ] However, it is a rare condition that presents clinical symptoms very similar to de Quervain's disease due to the anomalous course and tenosynovitis of extensor pollicis longus (EPL) tendon despite few published reports. [ 6 , 7 , 8 ]…”

Section: Introductionmentioning

confidence: 99%

Anomalous course and stenosing tenosynovitis of the extensor pollicis longus tendon at the radial styloid process

Lee

2018

Medicine

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Rationale:Anomalous course and tenosynovitis of extensor pollicis longus (EPL) tendon is a rare condition that presents clinical symptoms very similar to de Quervain's disease. Herein we report a case of anomalous course and tenosynovitis of the extensor pollicis longus (EPL) tendon associated with symptoms of de Quervain's disease.Patient concerns:A 44-year-old right-handed man visited the clinic because of radial pain associated with the left wrist, which was aggravated during the previous 10 days. The patient tested positive on the Finkelstein's test and displayed a limited range of motion of the left wrist. Motion of the thumb and wrist aggravated pain.Diagnoses:Magnetic resonance imaging (MRI) of the left wrist suggested mild tenosynovitis at the third extensor compartment and intersection syndrome. However, clinical symptoms failed to match the MRI findings.Interventions:A zig-zag skin incision on the radial styloid process was made. The operative findings revealed stenosing tenosynovitis with partial tearing. Retraction of the tendon extended the thumb interphalangeal joint, suggesting that the tendon was the EPL tendon rather than EPB tendon. After operation, we reviewed the MRI of the patient, which revealed that the oblique course of the EPL tendon originated from the ulnar side of the forearm to the radial styloid at the radial and proximal site of Lister's tubercle. No EPB tendon was present.Outcomes:At 12 months of follow-up, the patient's radial styloid process was completely asymptomatic and resumed full daily activities.Lessons:Anomalous course of the EPL tendon is rarely reported associated with similar symptoms of de Quervain's disease. However, the knowledge and understanding of this potential anomaly in the course of EPL tendon is very important for the treatment of de Quervain's disease to decrease patient dissatisfaction after surgery.

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Anomalous Course of the Extensor Pollicis Longus

Cited by 11 publications

References 16 publications

Anomalous Course of the Extensor Pollicis Longus With Multiple Absences of Thumb Muscles

Anomalous Course of the Extensor Pollicis Longus With Multiple Absences of Thumb Muscles

Variant course of extensor pollicis longus tendon in the second wrist extensor compartment

Anomalous course and stenosing tenosynovitis of the extensor pollicis longus tendon at the radial styloid process

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