Bilateral intersection syndrome.

A 52-year-old man had a 1-month history of bilateral wrist pain. Although the patient participated in weight-lifting activities, his symptoms began shortly after he mowed the grass. Physical examination revealed bilateral and painful fusiform swelling at the distal forearms (pictured) with crepitus noted at the right distal forearm. Two variants of the Finkelstein test were performed, the results of which indicated bilateral intersection syndrome. The patient was treated with bilateral wrist immobilization and ibuprofen (600 mg 4 times/d). Tenosynovitis is inflammation of a tendon sheath. Intersection syndrome is tenosynovitis that involves the second compartment muscles (ie, extensor carpi radialis longus and extensor carpi radialis brevis); De Quervain disease is a type of tenosynovitis that involves first compartment muscles (ie, extensor pollicis brevis and abductor pollicis longus). Repetitive resisted extension (eg, rowing, weight lifting, pulling) is a common mechanism of injury. The video of this patient’s examination with a discussion of these conditions can be viewed at https://files.me.com/lmellick/jwsipu.mov.