Intersection syndrome: MR imaging with anatomic comparison of the distal forearm

Souza-Lima, José Edmilson de; Kim, Hyun‐Jin; Albertotti, Flávio; Resnick, Donald

doi:10.1007/s00256-004-0832-4

Cited by 59 publications

(44 citation statements)

References 8 publications

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“…However, the intersection syndrome at the forearm is rare and is considered to be an overuse syndrome [3, 14–16]. Thus, we did not expect to find frank inflammation at the chiasma crurale, but rather some friction-related changes on the surfaces of the tendons, a finding that we often suggested upon analysis of clinical MR imaging examinations.…”

Section: Discussionmentioning

confidence: 75%

Chiasma crurale: intersection of the tibialis posterior and flexor digitorum longus tendons above the ankle. Magnetic resonance imaging–anatomic correlation in cadavers

et al. 2009

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Purpose To determine the precise anatomy and magnetic resonance (MR) imaging appearance of the chiasma crurale in cadavers, paying special attention to degenerative changes Material and methods Twelve fresh human ankles were harvested from 11 nonembalmed cadavers (mean age at death 77 years) and used according to institutional guidelines. MR imaging and MR tenography were used to investigate the anatomy of the chiasma crurale using proton density-weighted sequences. The gross anatomy of the chiasma crurale was evaluated and compared to the MR imaging findings. Histology was used to elucidate further the structure of the chiasma crurale. Results Above the chiasma, five specimens had a small amount of fat tissue between the tibialis posterior and flexor digitorum longus tendon. In all specimens both tendons had a sheath below the chiasma but not above it. At the central portion of the chiasma there was no soft tissue between the tendons, except in two specimens that showed an anatomic variant consisting of a thick septum connecting the tibial periosteum and the deep transverse fascia of the leg. In MR images, eight specimens showed what were believed to be degenerative changes in the tendons at the level of the chiasma. However, during gross inspection and histologic analysis of the specimens, there was no tendon degeneration visible. Conclusion At the central portion of the chiasma, there is no tissue between the tibialis posterior and flexor digitorum longus tendons unless there is an anatomic variant. At the chiasma crurale, areas with irregular tendon surfaces are normal findings and are not associated with tendon degeneration (fraying).

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Section: Discussionmentioning

confidence: 75%

Chiasma crurale: intersection of the tibialis posterior and flexor digitorum longus tendons above the ankle. Magnetic resonance imaging–anatomic correlation in cadavers

et al. 2009

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“…The underlying pathophysiologic mechanisms have yet to be defined [9,10], but two theories (not necessarily mutually exclusive) have been advanced. The first holds that the syndrome is caused by friction between the bellies of the abductor pollicis lungus and the extensor pollicis brevis muscles and the tendon sheaths of the extensor carpi radialis lungus and the extensor carpi radialis brevis [11].…”

Section: Discussionmentioning

confidence: 99%

The intersection syndrome: Ultrasound findings and their diagnostic value

Montechiarello

Miozzi

D'Ambrosio

et al. 2010

Journal of Ultrasound

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“…The anatomy of the first and second extensor compartment crossover has been well demonstrated with short tau inversion recovery (STIR) sequences being particularly helpful in identifying intersection syndrome 2 3. Peritendinous oedema or fluid surrounding the first and second extensor compartments is seen 3.…”

Section: Investigationsmentioning

confidence: 99%

Diagnosis and management of intersection syndrome as a cause of overuse wrist pain

Chatterjee

Vyas²

2016

BMJ Case Reports

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Wrist pain due to repetitive motion or overuse is a common presentation in primary care. This case reports the rare condition of intersection syndrome as the cause of the wrist pain in an amateur tennis player. This is a non-infectious, inflammatory process that occurs where tendons in the first extensor compartment intersect the tendons in the second extensor compartment. Suitable history and examination provided the diagnosis, which was confirmed by MRI. Management consisted of early involvement of the multidisciplinary team, patient education, workplace and sporting adaptations, rest, analgesia, reduction of load, protection and immobilisation of the affected joint followed by a period of rehabilitation.

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Intersection syndrome: MR imaging with anatomic comparison of the distal forearm

Cited by 59 publications

References 8 publications

Chiasma crurale: intersection of the tibialis posterior and flexor digitorum longus tendons above the ankle. Magnetic resonance imaging–anatomic correlation in cadavers

Chiasma crurale: intersection of the tibialis posterior and flexor digitorum longus tendons above the ankle. Magnetic resonance imaging–anatomic correlation in cadavers

The intersection syndrome: Ultrasound findings and their diagnostic value

Diagnosis and management of intersection syndrome as a cause of overuse wrist pain

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