Shawn thistle, certified functional anatomy seminars instructor discusses the intersection syndrome in the dorsal aspect of the forearm. Ray tracing and other techniques employ algorithms which require the intersection between a threedimensional parametric ray and an object. Intersection syndrome of the forearm is a painful condition in the area where the muscle bellies of the abductor pollicis longus and extensor pollicis brevis cross the common wrist extensors. Ray bilinear patch intersections university of utah. The condition is thought to occur as a result of repetitive friction at the junction in which the tendons of the first dorsal compartment cross over the second, creating tenosynovitis. Alternatively, forearm intersection syndrome is also known as crossover syndrome 2.
An exact and efficient 3d mesh intersection algorithm. Axial fatsuppressed proton densityweighted image in a 31 year old male. Intersection syndrome is an overuse disorder of the dorsal distal forearm, presenting with particular symptoms and signs that may be clinically misdiagnosed. Bilateral intersection syndrome aut ho rs i nt er es te d i n co nt ri bu ti ng to cl in ic al im ag es sh ou ld r efe r to t he j ao a s in fo rm at io n for c on tr ib ut or s. The examining physician must be convinced that the patients wrist or forearm pain is not due to inflammation or compression of other radialsided structures, such as the flexor carpi radialis fcr, tendons of the first extensor compartment, thumb cmc joint, or radial sensory nerve. Forearm intersection syndrome first described by velpeau in 1841 and explained that inflammation and pain develop at the intersection of the foremost and subsequent sections of dorsal extensor tendon due to overuse. The few articles that i could find on intersection syndrome very much supported my clinical and ultrasound findings. This is where two muscles cross over or intersect two underlying wrist tendons. Distal intersection syndrome radiology reference article.
Unlike other surfaces, solving the raybilinear patch intersection with simple algebraic manipulations fails. The upper muscle group tendons connect with the thumb to pull it away from the hand and the lower set of tendons bends back, or extends, the wrist. Intersection syndrome metro health hospital metro health. Intersection syndrome makes it extremely difficult to perform any tasks that require you to curl your wrist down or in towards your thumb. Unlike other sur faces, solving the raybilinear patch intersection with simple algebraic manipulations fails. Bilinear interpolation is a generalization of linear interpolation. The object to intersect is typically a sphere, triangle, or polygon but many surface types are possible. It seems that humpdoc and colleagues has selfdiagnosed as having this after the bcm, and i see to have the right symptoms too. Introduction intersection syndrome is a painful condition that affects the thumb side of the forearm where two muscles cross over or intersect two underlying wrist tendons. Follow up to questions 16 year old with wrist pain from intersection syndrome by. Bilinear interpolation, an extension of linear interpolation for interpolating functions of two variables on a rectilinear 2d grid. This is done in an e ort to remove the singularities present in our approach. I have clinically diagnosed this syndrome several times however on previous occasions there was no sign of tenosynovitis but it clinically resembled myotendinous junction syndrome with pain over the muscle rather than tendon. We present a complete, e cient, robust, and graceful formulation to solve raybilinear patch intersections quickly.
Compartment 2 intersection syndrome compartment 5 vaughnjackson syndrome compartment 6 snapping ecu pain over dorsal forearm and wrist. Hence such injuries are also referred to as the cumulative trauma disorders ctds, workrelated upper limb disorders. Intersection syndrome with associated muscular edema and subcutaneous edema. Intersection syndrome is a painful condition of the forearm and wrist. Intersection syndrome is an overuse tenosynovitis that occurs around the intersection of the first extensor compartment abductor pollicis longus and extensor pollicis brevis and second extensor compartment extensor carpi radialis longus and extensor carpi radialis breviswithin the forearm. It is also called oarsmens wrist because it is most common in sports like rowing, with repetitive wrist movements. A bilinear patch is defined by four points and as a parameter u sweeps out two opposite edges of the quadrilateral, the surface is formed by lines drawn between points on the opposite segments with equal values of u. Intersection syndrome occurs in occupations and sports activities that require repetitive wrist twisting and bending motions. It is important to change or stop any activities that are causing these symptoms. Intersection syndrome is an overuse tenosynovitis that occurs around the intersection of the first extensor compartment abductor pollicis longus and extensor pollicis brevis and second extensor compartment extensor carpi radialis longus and extensor carpi radialis brevis within the forearm. Nine months of conservative dqt therapy and a landmarkguided corticosteroid. The purpose of our study is to demonstrate the role of ultrasound as a firstline technique in the evaluation of intersection syndrome, reporting and illustrating its typical and atypical findings.
Bilinear interpolation, an extension of linear interpolation for interpolating functions of two variables on a rectilinear 2d grid bilinear map, a type of mathematical function between vector spaces bilinear transform, a method of transforming from the s to z domain in control theory and signal processing. In this work we consider intersections between rays and the simplest parametric surface, the bilinear patch. Physiotherapy in hamilton for wrist intersection syndrome. The intersection syndrome is a wellknown overuse syndrome of the distal forearm. Intersection syndrome, crossover tendinitis, tenosynovitis of the radial wrist extensors, extensor tenosynovitis of wrist. Intersection syndrome orthopedic surgery, algonquin, il. Intersection syndrome is a condition that affects the first and second compartments of the dorsal wrist extensors. So that were on the same page, have you gotten one of my ebooks or dvds. It is caused by overuse or injury from activities that use the wrist, such as weight lifting, heavy raking and shoveling, downhill skiing, or canoeing. This is similar to the intersection of two roads where one road has an overpass above the other. It can affect people who do repeated wrist actions, such as weight lifters, downhill skiers, and canoeists. This causes pain and swelling on the top of the forearm, just below the wrist.
Symptoms may include pain and swelling above the back of the wrist. Intersection syndrome symptoms, treatment, surgery, causes. Presented here is a 26yearold pregnant woman with a history of rowing who developed left radialdorsal wrist pain and a rubbingsqueaking sensation. Bilinear map, a type of mathematical function between vector spaces. The distal intersection syndrome relates to tenosynovitis of the extensor pollicis longus epl tendon 3rd extensor compartment, where it crosses the extensor. A similar case of the foot with marked fibrosis at the interconnection of flexor hallucis longus and flexor digitorum tendons is reported and the fibrous. Introduction repetitive strain injury rsi is typically a softtissue injury characterized by an inflammation of the muscles, nerves, ligaments or tendons. Heavy raking or shoveling can also cause intersection syndrome.
Physicians normally can make the diagnosis of intersection syndrome while doing a physical exam. Intersection syndrome is named for the intersection of four tendons on the back of the forearm near the wrist. Recently, the sharp l2bilinear adjoint restriction estimates for the cone and the paraboloid were established by wol. Intersection syndrome is an inflammatory overuse syndrome of the forearm characterized by painful swelling on the radial side of the distal forearm 4 to 8 cm proximal to listers tubercle. Intersection syndrome is a swelling and inflammation of the tendons that cross over the back of the wrist. Nonoperative rest, wrist splinting, steroid injections indications first line of treatment. The intersection area of the forearm is located at the musculotendinous junctures of the abductor pollicis longus apl and the extensor pollicis brevis epb as. Their results rely on the fact that for the cone and the paraboloid, the nonzero. Bilinear restriction estimates for surfaces with curvatures of different signs sanghyuk lee abstract.
The second type of uniform patch is a bicubic patch. Another common formulation of ray bilinear patch intersections represents the ray as the intersection of two planes see 3. At this spot, two muscles that connect to the thumb. The major controversies surrounding intersection syndrome pertain to diagnosis and pathophysiology. Anatomy the upper muscle group tendons connect with the thumb to pull it away from the hand and the lower set of tendons bends back, or extends, the wrist. Intersection syndrome is a painful condition that affects the lateral side of the forearm when inflammation occurs at the intersection of the muscle bellies of the abductor pollicis longus and extensor pollicis brevis cross over the extensor carpi radialis longus and the extensor carpi radialis brevis. It is characterized by noninfectious, inflammatory changes involving the area of intersection of the first abductor pollicis longus and extensor pollicis brevis and second extensor carpi radialis longus and extensor carpi radialis brevis extensor compartments in the dorsoradial aspect of the. If left untreated, the pain can travel all the way down to your elbow. Such an implementation changesthe ray equation and solves the system in much the same way as presented above. Trying to animate that object can make continuity very difficult, and if youre not very careful, your model will show creases and artifacts near patch seams. Intersection syndrome is commonly diagnosed in workers or athletes whose activities involve repetitive wrist flexion and extension 7,9,10 as well as repetitive, high compressive forces at the wrist.
In addition to peritendinous edema, there is overlying subcutaneous edema and adjacent edema in the extensor pollicis brevis epb and abductor pollicis longus muscles apl. Intersection syndrome is a type of tenosynovitis resulting in pain to the lower forearm, usually a few inches from the wrist. Intersection syndrome is a painful condition that affects the thumb side of the forearm. In fact, it is an umbrella term, used to refer to various kinds of workrelated muscoskeletal injuries. An exact and efficient 3d mesh intersection algorithm using only orientation predicates salles v. We present a case of intersection syndrome, describing its characteristic clinical and anatomic features, and highlighting differences in the areas of diagnosis and. The pain from intersection syndrome is usually felt on the top of the forearm, about three inches above the wrist. Intersection syndrome tenosynovitis of the radial wrist extensors is common cause of wrist pain but under diagnosed, because of an atypical. Tendons are thick, ropelike structures that connect muscle to bone. The majority of the time no distinctive tests are needed. The outcropping muscle bellies of the apl and epb intersect with the long radial wrist extensors on the dorsal radial aspect of the distal forearm. Ultrasound findings in intersection syndrome springerlink. The two muscles that control the thumb originate in the forearm, intersecting two wrist tendons before connecting to the thumb.
Recognizing the regional impact of specific forces to the wrist aids in accurate diagnosis of this condition and can lead to optimal treatment outcomes. Intersection syndrome more aptly describes the anatomy involved as this is an inflammatory condition occuring where the abductor pollicis longus and extensor pollicis brevis tendons cross the extensor carpiradialis brevis and extensor carpi radialis longus tendons in the forearm. Intersection syndrome occurs when the wrist extensor tendons become inflamed due to overuse. Intersection syndrome causes pain at the intersection point, about three inches up the forearm. The basic aim of musculoskeletal interventional ultrasonography is the injection of a therapeutic substance, usually a corticosteroid but in rare cases a visco supplement, into a specific site, a joint, tendon sheath, peritenon, retinaculum, serous bursa or an area of compression of a peripheral nerve. Radial sensory neuritis wartenberg syndrome may also present as distal radial forearm pain. This page includes the following topics and synonyms. A similar case of the foot with marked fibrosis at the interconnection of flexor hallucis longus and flexor digitorum tendons is reported and the fibrous interconnection was extended proximally. We present a complete and graceful formulation to solve raybilinear patch intersections quickly. Intersection syndrome is a condition that should be differentiated from dequervains stenosing tenosynovitis, as there are many subtle differences in treatment and prognosis. Both syndromes involve inflammation in the tendons of the wrist.