Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, aching pain localized to the proximal dorsal forearm, exacerbated by repetitive forearm rotation and resisted supination. No sensory deficits or motor weakness noted. Symptoms are consistent with compression of the posterior interosseous nerve at the radial tunnel.
Clinical Examination Findings
Right forearm examination reveals tenderness to palpation 3-4 cm distal to the lateral epicondyle. Resisted supination and resisted middle finger extension (Maudsleyโs test) elicit pain in the radial tunnel. Tinelโs sign is negative at the wrist. No atrophy of the extensor musculature.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of repetitive forearm rotation, and use of a neutral wrist splint. Prescribe NSAIDs for inflammation and refer to physical therapy for nerve gliding exercises and ergonomic assessment.