Superficial radial neuropathy: an unobserved etiology of chronic dorsoradial wrist pain

Saba, Emmanuel Kamal Aziz

doi:10.1186/s43166-021-00077-y

Cited by 4 publications

(7 citation statements)

References 34 publications

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“…Focal neuropathy of the superficial radial nerve (SRN) causes pain, burning, numbness, tingling, and dysesthesias of the dorsolateral aspect of the distal forearm and hand involving the dorsolateral three and a half fingers extending to the distal interphalangeal joint (1)(2)(3)(4)(5)(6). Initially reported in a patient with wrist watch compression in 1926 by Schlesigner and Matzdorff, this condition was later referred to as Wartenberg's syndrome after Wartenberg described 5 patients in 1932 with neuropathy involving the SRN (1-4, 7, 8).…”

Section: Introductionmentioning

confidence: 99%

“…The SRN is one of the 2 terminal branches of the radial nerve, derived from the C6 and C7 nerve roots (5). At the elbow, the radial nerve bifurcates into the deep motor branch (posterior interosseous nerve) and superficial, sensory branch (SRN) (2,(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

“…At the elbow, the radial nerve bifurcates into the deep motor branch (posterior interosseous nerve) and superficial, sensory branch (SRN) (2,(11)(12)(13). The SRN courses along the radial aspect of the forearm, running beneath the brachioradialis muscle on the lateral side of the radial artery, and piercing the deep fascia at about 9 cm proximal to the radial styloid (2,5,10,11,(13)(14)(15)(16). The SRN enters the hand traversing the anatomical snuffbox on the dorsolateral wrist, innervating the lateral two-thirds of the dorsum of the hand and lateral three and a half fingers to the level of the distal interphalangeal joints.…”

Section: Introductionmentioning

confidence: 99%

“…The only autonomous sensory region of the SRN is the dorsal web space closest to the thumb ( 2 ). Due to the superficial location of the SRN, it is vulnerable to a host of injuries, including trauma (direct blunt trauma to the radial aspect of the forearm which may cause post-traumatic fibrosis/adhesions with neuroma formation, work-related activities with repetitive supination and pronation movements), extrinsic compression (tight wrist watch, handcuffs, plaster cast), intrinsic compression (ganglion cyst, lipoma, abscess, bony spur), iatrogenic (fracture fixation and arthroscopic procedures in the lateral forearm, acupuncture/venipuncture-related injuries, local corticosteroid injections, IV lines/shunts and transradial cardiac catheterization ( 1–3 , 5 , 10–12 , 15 , 17 ). SRN neuropathy may also be idiopathic ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…The Finkelstein test (pain on the radial aspect of the wrist when the thumb is flexed into the palm and the wrist is ulnar deviated) may be positive in some cases leading to a mistaken diagnosis of de Quervain tenosynovitis, although it is common for both conditions to coexist ( 3 , 18 , 19 ). Patients with SRN neuropathy often attain symptom resolution with removal of the inciting factor such as a wrist watch, handcuffs, or plaster cast ( 1–3 , 5 , 12 ). Non-surgical management includes rest, splinting, a TENS unit, non-steroidal anti-inflammatory medications, gabapentin or duloxetine, topical application of a lidocaine/gabapentin compound, and minimizing repetitive actions that aggravate symptoms ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

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Etiological study of superficial radial nerve neuropathy: series of 34 patients

Shields

Iyer²,

Shields

2023

Front. Neurol.

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ObjectivesSuperficial radial nerve (SRN) neuropathy is a rare focal neuropathy leading to pain and paresthesia of the dorsolateral aspect of the hand. Reported causes include trauma, extrinsic compression, or it may be idiopathic. We describe the clinical and electrodiagnostic (EDX) features of 34 patients with SRN neuropathy of varied etiology.MethodsThis is a retrospective study of patients with upper limb neuropathy referred for EDX studies who were found to have SRN neuropathy based on clinical and EDX findings. Twelve patients also had ultrasound (US) evaluations.ResultsDecreased pinprick sensation was noted in the distribution of the SRN in 31 (91%) patients, and a positive Tinel’s sign was observed in 9 (26%). Sensory nerve action potentials (SNAPs) were not recordable in 11 (32%) patients. Of the patients who had a recordable SNAP, the latency was delayed, and the amplitude was decreased in all cases. Of the 12 patients who underwent US studies, 6 (50%) had an increased cross-sectional area of the SRN at or immediately proximal to the site of injury/compression. A cyst was located adjacent to the SRN in 2 patients. The most common cause of SRN neuropathy was trauma in 19 (56%) patients, of which 15 were iatrogenic. A compressive etiology was identified in 6 patients (18%). No specific etiology was detected in 10 patients (29%).ConclusionThis study is aimed at raising the awareness among surgeons about the clinical features and varied causes of SRN neuropathy; such knowledge may potentially lessen iatrogenic causes of injury.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Etiological study of superficial radial nerve neuropathy: series of 34 patients

Shields

Iyer²,

Shields

2023

Front. Neurol.

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Dorsal Wrist (Radial, Dorsal, Ulnar)

Greenberg,

Day,

Alradawi

2023

Manual of Musculoskeletal Ultrasound

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Posterior femoral cutaneous nerve sensory conduction study in a sample of apparently healthy Egyptian volunteers

Saba

2022

Egypt J Neurol Psychiatry Neurosurg

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Background Posterior femoral cutaneous nerve (posterior cutaneous nerve of the thigh) is a sensory nerve arises from the sacral plexus. Its terminal part supplies the skin of the posterior surface of the thigh and popliteal fossa, and it extends for a variable length below the popliteal fossa till the mid-calf region. The aim was to assess the posterior femoral cutaneous nerve antidromic sensory conduction technique and estimate its different sensory nerve action potential parameters’ reference values in a sample of apparently healthy Egyptian participants. One hundred and twenty lower limbs of 60 apparently healthy Egyptian volunteers were included. Clinical evaluation and sensory conduction study for the posterior femoral cutaneous nerve were done. Results Posterior femoral cutaneous nerve sensory nerve action potential was elicited in 98 lower limbs (81.6%) of 52 individuals (86.7%). The obtained results of different parameters of posterior femoral cutaneous nerve sensory nerve action potential were as the following: onset latency (2.04 ± 0.21 ms), peak latency (2.86 ± 0.25 ms), conduction velocity (59.45 ± 6.36 m/s) and amplitude (6.16 ± 2.29 μV). No significant differences between the two genders were found regarding different parameters of posterior femoral cutaneous nerve sensory nerve action potential except for amplitude which was significantly larger among male participants (P = 0.030). No significant differences between the right and left lower limbs were found regarding different parameters of sensory nerve action potential. There was a statistical significant negative correlation between age and posterior femoral cutaneous nerve conduction velocity (P = 0.008). There was a statistical significant positive correlation between height and peak latency (P ≤ 0.0001), as well as, a statistical significant negative correlation between height and conduction velocity (P ≤ 0.0001). There was a statistical significant negative correlation between body mass index and posterior femoral cutaneous nerve peak latency (P = 0.008). Conclusions The research provides a reliable electrophysiological antidromic sensory conduction study for the posterior femoral cutaneous nerve and normal cut-off reference values for posterior femoral cutaneous nerve sensory nerve action potential parameters. This is essential for the evaluation of suspected posterior femoral cutaneous nerve lesions.

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Superficial radial neuropathy: an unobserved etiology of chronic dorsoradial wrist pain

Cited by 4 publications

References 34 publications

Etiological study of superficial radial nerve neuropathy: series of 34 patients

Etiological study of superficial radial nerve neuropathy: series of 34 patients

Dorsal Wrist (Radial, Dorsal, Ulnar)

Posterior femoral cutaneous nerve sensory conduction study in a sample of apparently healthy Egyptian volunteers

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