Atraumatic proximal radial nerve entrapment. Illustrative cases and systematic review of literature

Transient Exertional Compressive Radial Neuropathy in a Collegiate Baseball Pitcher

“…Of note, additional sites of compression have been noted in close proximity to the intramuscular septum. In particular, the lateral head of the triceps origins proximally, the hiatus of the intramuscular septum itself, and distally fibrous tissue between the brachioradialis and lateral intramuscular septum 13 .…”

“…In addition, the symptoms he presented with were only present during times of exertion, rather than at rest. Laumonerie et al performed a systematic review of atraumatic proximal radial nerve compression 13 . They reported approximately 75% of patients who underwent decompression of the nerve experienced full neurologic recovery.…”

“…We report an unusual case of a collegiate baseball pitcher with pain and wrist extension weakness after short periods of pitching, consistent with an exertional compressive neuropathy of the radial nerve where it pierces the lateral intermuscular septum. Compressive neuropathy of the radial nerve can result as a consequence of trauma, such as a diaphyseal humerus fracture [10][11][12] , but can also occur without trauma, as a result of repetitive elbow extension and triceps contraction, in particular the lateral head, leading to pain and weakness 13,14 . In this case, symptoms of pain and weakness occurred only transiently with overhead pitching activities.…”