Intersection syndrome in Buriram Hospital - A 4-yr prospective study

Objective: To determine the prevalence, demographic characteristics, sympto ms, treatment, and outcome of patients who presented to Buriram Provincial hospital and were diagnosed with intersection syndrome. Design: This was a 4-yr prospective study that included all patients with n ew complaints of forearm and hand pain who presented to Buriram hospital as inpatients or outpatients. Results: The prevalence of intersection syndrome was found to be 0.37% of a ll patients (8080) with arm or hand pain. Of the 30 patients presenting wit h intersection syndrome, all had forearm pain, 22 (73.3%) had swelling, and 12 (40%) had crepitus noted in the intersected region. Fourteen (46.7%) pa tients reported pain provoked with twisting hand motions with radial deviat ions, 4 (13.3%) with pulling, and 12 (40%) with combinations of multiple ha nd movements (threshing, planting, hammering, hand washing, spraying and ce menting). The majority of the patients were male (70%) farmers (60%). Twent y-nine patients received nonoperative treatment, including modified work ac tivities to reduce stress on the wrist, nonsteroidal anti-inflammatory, and analgesic medications. One patient received only analgesic medication. One patient additionally required a resting hand splint. Every patient was see n for follow-up within the next 7 days. By 12-18 months posttreatment, ther e were only 14 patients (46.6%) remaining in follow-up, none with any sympt om recurrence. Conclusion: Intersection syndrome is a relatively uncommon, overused syndro me that is associated with repeated radial deviation of the wrist and respo nds favorably to conservative treatment.