Gibt es ein algetisches Supinatorsyndrom?

Abstract

The supinator (tunnel) syndrome is a rare chronic compression syndrome of the posterior interosseous nerve. The tennis elbow or the lateral epicondylitis and the algetic supinator syndrome represent painful entities of the lateral epicondyle and inserting tendons which do not have anything to do with a compression syndrome of the radial nerve. Decompression of the interosseous posterior nerve therefore has to be abandoned in the therapy for lateral elbow pain.

High resolution ultrasound in posterior interosseous nerve syndrome

“…Compression of the PIN results in paresis or paralysis in muscles innervated by the nerve. The PIN is considered a “motor only” nerve; therefore, compression typically does not cause any pain . However, this is a controversial issue without uniform agreement in the literature.…”

“…Pain in PIN syndrome may be a secondary phenomenon. It may not be directly attributable to nerve entrapment, but to additional changes in nearby soft tissue such as the supinator muscle or joints . Still some authors believe that pain of the supinator region is a primary symptom of PIN syndrome, probably attributed to small fibers in the vascular plexus of the nerve .…”

“…Still some authors believe that pain of the supinator region is a primary symptom of PIN syndrome, probably attributed to small fibers in the vascular plexus of the nerve . Some authors cogently criticize the classification into “painful” and “paralytic” PIN syndrome, refusing the possibility of a pain‐only phenomenon in a “pure” motor nerve . Rosenbaum named the “painful form” of the PIN syndrome “disputed radial tunnel syndrome,” assuming that there is no proof of its pathogenesis by nerve entrapment and that such an inappropriate designation “…can lead to ill‐conceived surgery.”…”

“…Wrist drop, typical for radial nerve palsy, is absent in this syndrome, because the extensor carpi radialis longus muscle is innervated by the common radial nerve. There is some controversy about the existence of a painful PIN syndrome, but typically, pain or focal tenderness is not a feature . While clinical presentation of PIN syndrome seems straightforward, its rarity makes establishment of a reliable diagnostic algorithm challenging.…”