Wartenberg syndrome
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and related keywords: Superficial radial nerve syndrome
Overview
Wartenberg syndrome, isolated neuropathy of the cutaneous branch of the radial nerve or Superficial radial nerve syndrome is described in 1932 by Wartenberg, and suggested the name cheiralgia paraesthetica.
Anatomy
The superficial radial nerve exits between the brachioradialis and the extensor carpi radialis longus tendons at the junction of the proximal two thirds to distal one third of the forearm. The superficial radial nerve then courses in a superficial subcutaneous plane to provide sensation to the dorsal aspect of the hand from the thumb to the junction of the ring and long fingers. Sensation to the digits is provided up to the area of approximately the dorsal proximal interphalangeal joint. [1] [2]
Sites of compression
Fascial bands in the subcutaneous plane at its exit site, the tendons of the brachioradialis, and the extensor carpi radialis longus tendons compress the nerve.
Symptoms
Patients report decreased sensation, paresthesia, and tingling in the distribution of the superficial radial nerve. A position Tinel and compression sign is present at the site of exit of the superficial radial nerve. The symptoms are often provoked by extreme pronation of the wrist.
Treatment
Nonsurgical treatment includes wrist splinting in a neutral position and anti-inflammatory medication, which may decrease symptoms in the early stages. Surgical treatment includes surgical resection of part of the brachioradialis tendon to allow for an easy glide motion of the superficial radial nerve at its exit point.