Name:
Intersection Syndrome and Steroid Injection Technique
Description:
Intersection Syndrome and Steroid Injection Technique
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Duration:
T00H05M00S
Embed URL:
https://stream.cadmore.media/player/92536a2f-36f6-4a9d-8329-890f092a3f14
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/92536a2f-36f6-4a9d-8329-890f092a3f14/Intersection Syndrome and Steroid Injection Technique.mp4?sv=2019-02-02&sr=c&sig=F8%2BRRFcqYaCiIzVigYG4Q%2BvnX3sO2%2FWcjefUbUPgBTc%3D&st=2024-11-23T11%3A37%3A09Z&se=2024-11-23T13%3A42%3A09Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello viewers today I'm going to talk to you about a clinical condition which is called an intersection syndrome. Now, intersection syndrome is an uncommon cause of pain across the distal aspect of the wrist. Now, if you are a general practitioner or orthopedic surgeon or a physiotherapist, because this condition is uncommon, sometimes diagnosing this condition can be challenging.
So I'll take you through what is an intersection syndrome. And I will also talk about how to do a steroid injection. Now, intersection syndrome is also known as crossover syndrome or peritendinitis crepitans. It is also called as a subcutaneous perimyositis. So it is known by a lot of other names. Now, if you talk about the symptoms now the symptoms that are usually associated with intersection syndrome is pain across the wrist.
So if you see my wrist, you will usually see pain. If this is the wrist, this is the wrist joint, then the symptoms you will see swelling, pain across this region and it's usually 4 to 8 centimeters proximal to the radial steroid or roughly the wrist joint. And it is usually seen in a rowers or weightlifters, but in developing countries, in my experience, I see much more frequently in Malou and manual laborers, which involve in repeated activities of lifting heavy weight.
So if you are a patient, if you have got pain and swelling across this region, then you should think of intersection syndrome. So this is the gentleman who is a laborer by profession, and he has come to my clinic with pain and swelling in this right hand. Usually it affects the dominant hand because that is the hand which you use it more often for your day to day activities.
Now, if you see the difference between the two hands, if you see here. And if you see here, you can appreciate there is a lot of swelling in this region. So if you see a lot of swelling in this region, you should be thinking of intersection syndrome. Now, the other common condition, which is more common and it is and is the cause of pain across the distal aspect of the wrist is a decurvence. Now decurvence
pain and tenderness will be more closer to the radius. So this is I have marked the radius steroid and the extensor reticulum is pretty close to it. So pain across in this region is usually associated with decurvence. In intersection syndrome pain is much more proximal. So I have explained this in my wrist examination video. So if you see pain here, it's much more proximal. So if I press here, he doesn't like it and it involves a larger area and if you see a decurvence, it will be far more distal.
So this is at least 4 to 8 centimeters proximal. So all this area, if I can draw it up for you. This is all swollen. Now what is the special test? Now there is if you are careful enough, the swelling itself is a giveaway. So the test that you will read in books is if you ask the patient to passively extend the thumb or extend the wrist, then you will feel a crepitans here.
And what I do is it's very easy. I just put my hand over the swollen area and I ask the patient to do active wrist extension and flexion and I can feel a grating in this area and a crepitans, and that clinches the diagnosis of intersection syndrome. So in terms of treatment, when the patient comes to you, I think activity, modification and rest is extremely important.
So if you are a patient, modify your activities, try to give that hand some rest, take some anti-inflammatories, and that might help you to settle your symptoms down. Occasionally, you may need to splint it so you can have a plaster or a fortura splint just to give rest to that area. Majority of the patients will get better with these non operative treatments, especially activity, modification, anti-inflammatory and splints.
If it doesn't get better, then sometimes you need to give a steroid injection. And in this video, I'm going to show you how I do injection for this particular condition as well. And rarely if it doesn't get better with all this and if you have failed to relieve the symptoms even after steroid injection, then you may need to some time decompress and perform a surgery. So let's see how to do injection for this condition.
So first, we are going to clean the. ...[VIDEO ENDS]
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