桡骨管综合征资料 In-depth

您的感受

桡骨管综合征会导致肘部和前臂外侧出现深层酸痛。压痛点通常位于肘部外侧骨性隆起下方约 3 至 5 厘米处。按压该部位比按压其他任何位置都更疼痛。

疼痛往往在活动后加剧。手掌向上翻转、前臂旋转，或抓握和提举重物都可能使症状恶化。酸痛感可能向前臂和手腕的后侧放射。休息通常能缓解症状，且疼痛往往在您下次进行相同任务时再次出现。

需要反复扭转或抓握的日常任务可能变得困难。使用螺丝刀、打开罐子、使用锤子或拧干湿布都可能引发酸痛。有些人发现，与活动过程中相比，在工作或运动后症状更为明显。

与肘部和腕部周围的其他一些神经问题不同，本病通常不会引起麻木或刺痛感。神经功能仍然正常。这是该病症令人困惑的原因之一，因为疼痛感真实存在，但神经功能测试往往显示正常。

该名称具有一定的误导性。桡骨管并非单一的狭窄通道。它是桡神经走行路径上的一段区域，在此处有多个不同结构可能对其产生压迫。这些结构包括肌肉边缘、纤维带以及跨越神经的小血管。在这些任何一点上的压迫都可能引起相同的深层酸痛。

由于其他几种疾病也可能导致肘部外侧类似的疼痛，您的外科医生将仔细检查疼痛的确切位置以及诱发因素。获得正确的诊断至关重要，因为每种病因的治疗方案各不相同。

实际发生了什么

桡神经沿手臂下行，经过肘部，最终到达手部。在肘部下方不远处，它分为两个分支。一个分支负责传递手背的感觉。另一个分支称为骨间后神经，负责传递控制手腕和手指运动的信号，同时也携带来自腕关节的痛觉纤维。

在这段神经路径上，有几个不同的结构紧邻其旁。肌肉边缘、坚韧的纤维带以及横跨神经的小血管，都可能对其产生压迫。这些压力点中的任何一个都可能导致您感觉到的肘部外侧的深层酸痛。

神经的结构设计使其能够滑动。当您弯曲和伸直肘部或旋转前臂时，神经会轻微滑动以跟上运动。如果这种滑动受到限制，每次扭转或抓握时神经都会受到牵拉。反复的牵拉会刺激神经，这种刺激表现为疼痛。

这种情况在神经问题中较为罕见。神经功能仍然正常，因此手部力量和感觉良好，神经测试结果显示正常。受到影响的是神经内部的一组传导疼痛的纤维。这就是为什么主要症状是深层酸痛，而不是麻木或无力。

由于压力点位于肘部外侧附近，这种情况常被误认为是网球肘，即前臂肌腱附着于骨骼处的劳损。两者甚至可能同时发生。区分二者很重要，因为治疗方法不同。您的外科医生会检查确切的痛点以及症状的表现，以进行鉴别。

大多数病例无需手术即可恢复。休息、活动调整和其他非手术治疗是首选。手术减压仅保留给那些尽管采取了上述措施仍未改善的病例。

我们如何处理该问题

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 医生会从适合您病情的最微创方案入手。患者通常由全科医生（GP）转诊至我们的诊所；如果理疗师建议您就诊，您仍需获得全科医生的转诊才能符合 Medicare 报销资格。在您的首次就诊时，我们会采集病史、检查您的肘部，并在必要时安排影像学检查。普通 X 光片通常是首选的初步检查。磁共振成像（MRI）扫描可确认神经受压情况，并排除疼痛的其他病因。

针对此病症，非手术治疗为首选。我们通常从休息和调整诱发疼痛的活动开始。这可能意味着暂时减少重复性的扭转、抓握或提举动作。物理治疗旨在平息炎症，使神经能够顺畅滑动而不受牵拉。腕部支具固定也可作为早期治疗的一部分。在考虑进一步措施之前，我们会对这些疗法进行充分尝试。

我们不针对此病症使用注射治疗，因此不会为您提供皮质类固醇注射或类似治疗。止痛药和抗炎药（即您可能在药房购买的药物）可以帮助缓解症状，以便其他措施发挥作用。它们治疗的是症状而非病因。

当经过规范的非手术治疗尝试后疼痛仍未改善时，我们会考虑手术。该手术称为桡骨管松解术。其原理是找到神经沿途每个受结构压迫的部位并解除压迫，同时保持神经的血供不受影响。由于可能存在多个压迫点，我们会检查并松解神经的整个受累段。我们会与您讨论手术是否适合您，并共同做出决定。

预期情况

对于大多数人而言，该病症通常表现为缓慢且顽固的病程，而非突发性发作。疼痛往往在休息后缓解，并在进行相同活动时再次加剧，因此，如果引发症状的活动持续存在，疼痛可能会持续数月反复出现。首选非手术治疗，许多病例经此治疗可得到改善。如果经过充分尝试这些措施后疼痛仍未缓解，对于顽固性病例，可考虑手术以解除压迫。

神经受刺激后的恢复需要时间。由于神经愈合缓慢，改善通常发生在数周至数月内，而非数天内。您可能会先注意到深层疼痛有所缓解，随后发现随着刺激消退，扭转、抓握和提举动作变得更加舒适。有些人会稳步改善；另一些人则发现疼痛持续存在，或在恢复相同的重复性工作时疼痛复发。设定现实的目标很重要，因为目标是获得一只舒适且能正常工作的手臂，而非承诺完全无痛。

如果进行了手术并解除了压迫点，许多人可获得持久的疼痛缓解。但手术并非对所有人都有效，有些人疼痛可能持续存在或复发。此外，并不存在单一部位能解释所有病例，这也是结果存在差异的原因之一。如果该病症未得到处理且相同活动持续进行，疼痛通常会持续存在或反复出现，而不会自行消失。

另一种不同的情况是，支配手腕和手指运动的神经分支受到足够强烈的压迫，从而影响其信号传导，其表现有所不同。在这种情况下，可能出现手腕和手指无力，如果这种情况发生在附近手术后，通常会在3个月内缓解，最迟不超过5个月。您的外科医生会告知您是否属于这种情况，因为这种情况的预后和治疗计划与仅表现为疼痛的情况不同。

何时就医

如果您肘部外侧出现反复出现的深部酸痛，尤其是肘部骨性突起下方约 3 至 5 厘米处有一个压痛点，且前臂旋转会加重疼痛，请咨询您的全科医生。如果经过充分休息和活动调整尝试后疼痛仍未缓解，或疼痛持续影响工作，请要求专科医生评估。该病症通常不会引起麻木、刺痛或无力，因此如果出现这些症状，请告知您的全科医生，因为这提示可能存在需要尽早检查的其他神经问题。

深入探讨

Advanced reading: the deeper science (optional)

本节内容超出了您做出自身治疗决策所需的深度。桡骨管综合征值得额外阅读，原因令人不适：该网站所涉疾病中，其证据基础最为薄弱，且不存在可确诊该病的检查手段。明确告知其不确定性，应成为任何手术决策的一部分。

无确诊试验

大多数神经卡压均可被证实。腕管综合征表现为腕部传导速度减慢；肘管综合征表现为肘部传导速度减慢。桡骨管综合征通常不表现出此特征，因为受累的神经分支支配肌肉而非皮肤，因此没有麻木区域可供定位，且神经传导研究通常正常。

因此，诊断依赖于疼痛模式、位于外上髁远端数厘米处（而非外上髁上方）的压痛，以及对局部麻醉阻滞的反应。上述每一项均具有提示意义；但无一具有决定性。当代综述指出关于诊断和预后均存在持续争议 [1]。

其实际后果是与网球肘的高混淆率，后者位置紧邻且可共存。对良好治疗无反应的持续性“网球肘”是最终考虑桡骨管综合征的最常见情况之一。

治疗该疾病的证据确实非常薄弱

一项关于干预措施的系统性综述发现，手术减压可能有效，而更引人注目的发现是，保守治疗的有效性尚不明确，因为其中大多数根本没有相关研究 [2]。

这并非通常所说的“证据有限”的表述。对于该疾病提供的多数非手术治疗，相关研究尚未开展。目前的综述仍将非手术治疗置于首位，将减压手术作为难治性病例的可行选择 [1]，这种排序反映的是合理的谨慎态度，而非已证实的优越性。

这对决策意味着什么

由此可得出两点结论，且二者方向相反。

反对早期手术：由于诊断无法确诊，手术可能是在减压一个并非病因来源的神经。当减压手术失败时，往往难以判断是手术操作不充分，还是诊断本身有误。

支持在合适患者中考虑手术：同样缺乏支持替代方案的循证依据，因此等待并非人们所假设的有循证支持的选项。它仅仅是风险较低的选择。

合理的立场是：在此处，一个有把握的诊断比本站其他任何地方都更为重要。这包括：病史一致、体格检查将病变定位至桡骨管而非外上髁、影像学检查排除占位性病变，以及理想情况下，在采取不可逆步骤之前，诊断性神经阻滞产生令人信服的疗效反应。

参考文献

[1] Wolf JM, Patel R, Ghosh K. Radial tunnel syndrome: review and best evidence. J Am Acad Orthop Surg. 2023;31(15):813-9. https://doi.org/10.5435/JAAOS-D-23-00314

[2] Huisstede B, Miedema HS, van Opstal T, de Ronde MT, Verhaar JA, Koes BW. Interventions for treating the radial tunnel syndrome: a systematic review of observational studies. J Hand Surg Am. 2008;33(1):72.e1-72.e10. https://doi.org/10.1016/j.jhsa.2007.10.001

[3] McGraw I. Isolated spontaneous posterior interosseous nerve palsy: a review of aetiology and management. J Hand Surg Eur Vol. 2018;44(3):310-6. https://doi.org/10.1177/1753193418813788

[4] Sigamoney KV, Rashid A, Ng CY. Management of atraumatic posterior interosseous nerve palsy. J Hand Surg Am. 2017;42(10):826-30. https://doi.org/10.1016/j.jhsa.2017.07.026

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [3].
The primary issue surrounding radial tunnel syndrome has traditionally been properly identifying it clinically [2].
The Rule-of-Nine test effectively specifies the site of tenderness for the diagnosis of radial tunnel syndrome [4].
A prospective evaluation of corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome [5].
Nonsurgical management is first-line for radial tunnel syndrome [1].
Surgical decompression remains a viable option for refractory cases of radial tunnel syndrome despite ongoing controversy regarding diagnosis and outcomes [1].
Pain in patients with radial tunnel syndrome may be treated successfully by surgical decompression of the superficial branch of the radial nerve [12].
In high radial nerve entrapment neuropathy cases resistant to conservative treatment, surgery is advocated with emphasis on dissecting the entire length of the fibrous tunnel [6].
A study on high-resolution dynamic ultrasonography for posterior interosseous nerve compression acknowledges that it does not establish diagnostic accuracy or a reference standard for radial tunnel syndrome [15].

Anatomy & Pathophysiology

Radial Tunnel Anatomy

The radial tunnel is a potential space located anterior to the proximal radius through which the posterior interosseous nerve (PIN) passes [8].
The radial tunnel extends for approximately 5 cm starting from the level of the humeroradial joint and extending past the proximal edge of the supinator [8].
The radial tunnel is bound on the lateral side by the brachioradialis, extensor carpi radialis longus, and extensor carpi radialis brevis muscles [8].
The radial tunnel is bound on the medial side by the supinator muscle [8].
The posterior interosseous nerve crosses the radial head midline [55].
Supination of the forearm increases the linear distance between the posterior interosseous nerve and the radial head [55].
Predictive accuracy for posterior interosseous nerve localization in the proximal forearm was highest when the arm was in a supinated position [66].

Pathophysiology & Etiology

Radial tunnel syndrome is a pain syndrome presumed to be caused by compression of the posterior interosseous nerve at the proximal forearm [8].
There is dispute over the etiology of radial tunnel syndrome, with skeptics noting that its signs and symptoms contrast from other well-described entrapment neuropathies [7].
Skeptics note that radial tunnel syndrome presents with prominent focal tenderness, normal neurologic function, and no confirmatory electrodiagnostic evidence of nerve dysfunction [7].
Focal tenderness at the radial tunnel in radial tunnel syndrome differs from a positive Phalen's test in carpal tunnel syndrome because symptoms do not occur in the distribution of the purportedly affected nerve [7].
The posterior interosseous nerve carries unmyelinated (group IV) afferent fibers from the wrist capsule [7].
The posterior interosseous nerve carries small myelinated (group IIA) afferent fibers from the muscles along its distribution [7].
Unmyelinated group IV fibers from muscles are associated with nociception and pain [7].
There are no specific electrodiagnostic findings for radial tunnel syndrome [8].

Classification

There is dispute over the etiology of radial tunnel syndrome, with skeptics noting that its signs and symptoms contrast from other well-described entrapment neuropathies such as carpal tunnel syndrome and cubital tunnel syndrome [7].
Focal tenderness at the radial tunnel in radial tunnel syndrome differs from a positive Phalen's test in carpal tunnel syndrome in that the symptoms do not occur in the distribution of the purportedly affected nerve [7].
Radial tunnel syndrome and posterior interosseous nerve compression are distinct entities with different clinical presentations but share identical potential sites of nerve interference [14].
The author proposes unifying radial tunnel syndrome and posterior interosseous nerve compression as mild and severe forms of one disease to simplify nomenclature [14].
The authors advocate for consistent use of the terminology distinguishing the deep branch of the radial nerve and the posterior interosseous nerve [24].
The authors recommend viewing radial tunnel syndrome and posterior interosseous nerve syndrome as a single condition presenting along a spectrum of nerve entrapment [24].
The study provides credence to the concept that radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve [9].
The prevalence of radial tunnel syndrome in a representative United States insurance database was 0.091% [70].
The annual incidence of radial tunnel syndrome in a representative United States insurance database was 0.0091% [70].
Approximately 5.7% of the patients with radial tunnel syndrome also had a diagnosis of lateral epicondylitis on the same side within 6 months of radial tunnel syndrome diagnosis [70].

Clinical Presentation

Diagnostic Criteria and Physical Findings

Diagnosis of radial tunnel syndrome depends on clinical presentation and physical findings [8].
Prominent focal tenderness in the area of the radial tunnel is one of the principal diagnostic criteria for radial tunnel syndrome [7].
Clinical diagnosis criteria for radial tunnel syndrome include activity-related pain, maximal tenderness 3–5 cm distal to the lateral epicondyle, pain exacerbation with forearm supination, radiation to the dorsoradial aspect of the forearm, and a positive Lister test [42].
A positive Lister test is defined as pain with resisted middle finger extension [42].
Patients required to have at least 4 of the 5 diagnostic signs and symptoms for a clinical diagnosis of radial tunnel syndrome, with maximal tenderness 3–5 cm distal to the lateral epicondyle being mandatory [42].
Physical examination maneuvers to elicit radial tunnel syndrome include wrist flexion and forearm pronation, the Rule of Nines test, and weakness and pain with resisted long finger extension [46].
The history for radial tunnel syndrome is characterized by extensor musculature "forearm aching" [46].

Neurologic and Electrodiagnostic Features

Skeptics note that radial tunnel syndrome presents with normal neurologic function, contrasting with other well-described entrapment neuropathies [7].
Skeptics note that there is no confirmatory electrodiagnostic evidence of nerve dysfunction in radial tunnel syndrome [7].
Focal tenderness at the radial tunnel differs from a positive Phalen's test in carpal tunnel syndrome because symptoms do not occur in the distribution of the purportedly affected nerve [7].
The posterior interosseous nerve carries unmyelinated (group IV) afferent fibers from the wrist capsule and small myelinated (group IIA) afferent fibers from the muscles along its distribution [7].

Differential Diagnosis and Controversy

There is dispute over the etiology of radial tunnel syndrome, with skeptics noting its signs and symptoms contrast from carpal tunnel syndrome and cubital tunnel syndrome [7].
Radial tunnel syndrome and posterior interosseous nerve syndrome may be viewed as a single condition presenting along a spectrum of nerve entrapment [24].
Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve, leading to painful and dysesthetic symptoms at the lateral aspect of the elbow [16].
Patients with superficial radial nerve compression due to type A ganglion cysts are often initially diagnosed and managed as lateral epicondylitis [16].

Investigations

Clinical Diagnosis and Controversy

Radial tunnel syndrome is a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm [8].
The diagnosis of radial tunnel syndrome depends on clinical presentation and physical findings [8].
The primary issue surrounding radial tunnel syndrome is properly identifying it clinically [2].
Radial tunnel syndrome is described as an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [3].
The lack of specific electrodiagnostic and pathophysiologic findings makes radial tunnel syndrome somewhat controversial [8].

Electrodiagnostics

Understanding the anatomic course and distribution of the radial nerve is important to make an accurate diagnosis [11].

Imaging

Magnetic resonance imaging provides credence to the concept that radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve [9].
Dynamic ultrasonographic assessment of changes in the anteroposterior diameter and cross-sectional area is an effective diagnostic tool for identifying radial tunnel syndrome [64].
A study on high-resolution dynamic ultrasonography for posterior interosseous nerve compression does not establish diagnostic accuracy or a reference standard for radial tunnel syndrome [15].
Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve, which can present with symptoms initially diagnosed as lateral epicondylitis [16].
Magnetic resonance imaging can reveal the presence of a mass compatible with a ganglion cyst coming from the radiocapitellar joint that pushes up the superficial sensory branch of the radial nerve [16].

Treatment

Non-Operative

Nonsurgical management is the first-line treatment for radial tunnel syndrome [1].
The two most common nerve entrapment disorders about the elbow, including radial tunnel, should be initially managed conservatively before considering surgical intervention [41].
A prospective evaluation of a single corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome [5].
A prospective evaluation of a single corticosteroid injection in radial tunnel syndrome was conducted by authors who declared no potential conflicts of interest and received no financial support for the research [22].

Operative

Surgical decompression remains a viable option for refractory cases of radial tunnel syndrome [1].
There is a tendency that surgical decompression of the radial tunnel might be effective in patients with radial tunnel syndrome [48].
In high radial nerve entrapment neuropathy cases resistant to conservative treatment, surgery is advocated with an emphasis on dissecting the entire length of the fibrous tunnel [6].
There has been no randomized controlled trial that compares surgical with nonsurgical treatment or with a placebo for radial tunnel syndrome [7].

Complications

Nerve injury is an uncommon though troublesome complication of fractures or dislocations of the elbow [18].
Workers' compensation patients and those with associated lateral epicondylitis may have less successful outcomes following surgical treatment for radial tunnel syndrome [8].

Recovery

Prospective evaluation of corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome [5].
Isolated posterior interosseous nerve neurectomy has shown excellent clinical outcomes, with few patients experiencing recurrent pain at long-term follow-up [30].

Key Evidence

[L4] The article reviews the anatomy, diagnosis, and treatment of radial tunnel syndrome, noting that while nonsurgical management is first-line, surgical decompression remains a viable option for refractory cases despite ongoing controversy regarding diagnosis and outcomes. [1] (10.5435/jaaos-d-23-00314)
[L5] The issue surrounding radial tunnel syndrome traditionally has been properly identifying it clinically. [2] (10.1097/01.bth.0000231580.32406.71)
[L5] Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis. [3] (10.1016/j.jhsa.2010.03.020)
[L4] The Rule-of-Nine test effectively specifies the site of tenderness for the diagnosis of radial tunnel syndrome. [4] (10.1177/230949900401200115)
[L4] Prospective evaluation of corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome. [5] (10.1016/j.jhsa.2017.06.095)
[Case_report] The authors advocate for surgery in high radial nerve entrapment neuropathy cases resistant to conservative treatment, emphasizing the importance of dissecting the entire length of the fibrous tunnel. [6] (10.1016/j.jse.2025.02.060)
[L5] [7] (10.1016/j.jhsa.2009.10.016)
[L5] [8] (10.1016/j.ocl.2012.07.022)
[L4] The study provides credence to the somewhat disputed concept that radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve. [9] (10.1148/radiol.2401050028)
[L5] It is important to understand the anatomic course and distribution of the radial nerve in order to make an accurate diagnosis. [11] (10.1007/s11420-011-9238-8)
[L4] This study indicates that pain in patients with radial tunnel syndrome may be treated successfully by surgical decompression of the superficial branch of the radial nerve. [12] (10.1177/1753193408099832)
[L5] Radial tunnel syndrome (RTS) and posterior interosseous nerve (PIN) compression are distinct entities with different clinical presentations but share identical potential sites of nerve interference; the author proposes unifying them as mild (RTS) and severe (PIN compression) forms of one disease to simplify nomenclature. [14] (10.1177/1753193420953990)
[Paper] The authors acknowledge that their study does not establish diagnostic accuracy or a reference standard for radial tunnel syndrome. [15] (10.1177/17531934261463150)
[L4] [16] (10.1016/j.otsr.2016.05.014)
[L4] Nerve injury is an uncommon though troublesome complication of fractures or dislocations of the elbow. [18] (10.1016/s0020-1383(79)80015-7)
[L4] [22] (10.1177/1558944718787282)
[L5] The authors advocate for consistent use of the terminology distinguishing the deep branch of the radial nerve (DBRN) and the posterior interosseous nerve (PIN), and recommend viewing radial tunnel syndrome and posterior interosseous nerve syndrome as a single condition presenting along a spectrum of nerve entrapment. [24] (10.1177/17531934241254706)
[L4] Isolated PINN have shown excellent clinical outcomes, with few patients experiencing recurrent pain at long-term follow-up. [30] (10.1177/1558944717692093)
[L2] [42] (10.1016/j.jhsa.2024.09.023)
[L4] There is a tendency that surgical decompression of the radial tunnel might be effective in patients with RTS. [48] (10.1016/j.jhsa.2007.10.001)
[L5] Supination increases the linear distance between the PIN and radial head and should be considered to increase the safe working volume whenever intra-articular procedures are performed on the anterolateral aspect of the elbow. [55] (10.1016/j.jse.2018.08.019)
[L4] Dynamic ultrasonographic assessment of changes in the AP diameter and CSA is an effective diagnostic tool for identifying radial tunnel syndrome. [64] (10.1177/17531934261443138)
[L5] Predictive accuracy was highest when the arm was in a supinated position. [66] (10.1016/j.arthro.2013.03.056)
[L3] [70] (10.1016/j.jhsa.2023.03.007)

References

[1] Radial Tunnel Syndrome: Review and Best Evidence. Journal of the American Academy of Orthopaedic Surgeons. 2023. DOI: 10.5435/jaaos-d-23-00314

[2] A Unified Approach to Radial Tunnel Syndrome and Lateral Tendinosis. Techniques in Hand & Upper Extremity Surgery. 2006. DOI: 10.1097/01.bth.0000231580.32406.71

[3] Radial Tunnel Syndrome. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.03.020

[4] A New Clinical Test for Radial Tunnel Syndrome—The Rule-of-Nine Test: A Cadaveric Study. Journal of Orthopaedic Surgery. 2001. DOI: 10.1177/230949900401200115

[5] Prospective Evaluation of Single Corticosteroid Injection in Radial Tunnel Syndrome. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.095

[6] High radial nerve entrapment neuropathy: an anatomical cadaver study and case report. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2025.02.060

[7] Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.10.016

[8] Radial Tunnel Syndrome. Orthopedic Clinics of North America. 2012. DOI: 10.1016/j.ocl.2012.07.022

[9] MR Imaging Features of Radial Tunnel Syndrome: Initial Experience. Radiology. 2006. DOI: 10.1148/radiol.2401050028

[11] Posterior Interosseous Neuropathy: Electrodiagnostic Evaluation. HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery. 2012. DOI: 10.1007/s11420-011-9238-8

[12] Radial Tunnel Syndrome: Emphasis on the Superficial Branch of the Radial Nerve. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408099832

[14] Radial tunnel syndrome: definition, distinction and treatments. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420953990

[15] Re: Role of high-resolution dynamic ultrasonography in the evaluation of posterior interosseous nerve compression at radial tunnel: a prospective case-control study. Journal of Hand Surgery (European Volume). 1934. DOI: 10.1177/17531934261463150

[16] Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve. Orthopaedics & Traumatology: Surgery & Research. 2016. DOI: 10.1016/j.otsr.2016.05.014

[18] Acute nerve injury as a complication of closed fractures or dislocations of the elbow. Injury. 1979. DOI: 10.1016/s0020-1383(79)80015-7

[22] Prospective Evaluation of a Single Corticosteroid Injection in Radial Tunnel Syndrome. HAND. 2018. DOI: 10.1177/1558944718787282

[24] Nomenclature of the radial nerve: distinguishing between the deep branch of the radial nerve and the posterior interosseous nerve. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241254706

[30] Outcomes Following Isolated Posterior Interosseous Nerve Neurectomy: A Systematic Review. HAND. 2017. DOI: 10.1177/1558944717692093

[41] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Elbow Degenerative Conditions and Nerve Disorders > Summary.

[42] Investigating the Effect of Triamcinolone Local Injection on Clinical Outcomes of Patients With Radial Tunnel Syndrome: A Placebo-Controlled Clinical Trial. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.09.023

[46] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Anatomy, Biomechanics, Physical Examination, and Imaging of the Elbow > Biomechanics > Clinical Examination.

[48] Interventions for Treating the Radial Tunnel Syndrome: A Systematic Review of Observational Studies. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.10.001

[55] The posterior interosseous nerve crosses the radial head midline and increases its distance from bony structures with supination of the forearm. Journal of Shoulder and Elbow Surgery. 2019. DOI: 10.1016/j.jse.2018.08.019

[64] Role of high-resolution dynamic ultrasonography in the evaluation of posterior interosseous nerve compression at radial tunnel: a prospective case-control study. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934261443138

[66] Posterior Interosseous Nerve Localization in the Proximal Forearm: A Cadaveric Study Establishing a Non‐invasive, Patient‐normalized Parameter (SS‐49). Arthroscopy. 2013. DOI: 10.1016/j.arthro.2013.03.056

[70] The Epidemiology of Radial Tunnel Syndrome and Its Overlap With Lateral Epicondylitis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.03.007

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