Plancher History and Clinical Presentation A 35-year-old woman presents to our office with symptoms of forearm discomfort consisting of fatigue-like pain and numbness in her hand. [musculoskeletalkey.com]

We present this case to alert dentists, both male and female, of an uncommon but definite occupational hazard. [ncbi.nlm.nih.gov]

Concomitant carpal tunnel syndrome and pronator syndrome may be present (double-crush phenomenon). [hartfordsportsorthopedics.com]

Weakness could be present with abduction of the thumb as well as impairment to the pincer muscles. Sensation changes may also be experienced in the first three fingers and the palm. [physio-pedia.com]

• Pain

  Local pressure to the proximal volar surface of the forearm on the pronator teres muscle was painful, pain also could be provoked by supination of the forearm against resistance. [thieme-connect.com]

  The deeper the red, the more common the pain is if trigger points or too much muscle tension are present. 1.2 Impaired or painful movements With an abnormal tension and/or trigger points in the pronator teres, you might have pain and difficulties supinating [muscle-joint-pain.com]

  PATIENTS AND METHODS: The typical symptoms were pain, tingling, and numbness of the radial 3½ digits. [ncbi.nlm.nih.gov]

  Median Nerve Injury See Also Internal Hand and Wrist Anatomy (Main) Wrist Pain (Main) Forearm Pain (Main) Elbow Pain (Main) Physical Exam Wrist Neuropathies (Main) External Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist [wikism.org]

  Seror reviewed 117 published cases of AIS, and found that 85% reported symptoms of pain, but that pain was not predictive of an inflammatory or mechanical origin [31]. [gms-books.de]

• Weakness

  In the non-surgical group, focal tenderness was found in 12 out of 14, and 10 out of 14 showed the same weakness as in an earlier examination. [ncbi.nlm.nih.gov]

  This is usually accompanied by the perception of "hand weakness," and "dropping things." [en.wikipedia.org]

  Referral for guided corticosteroid injections or surgical decompression should be considered in resistant cases or where there is significant weakness Reference: Arthritis Research UK (2011). Hands On (11) - upper limb in primary care. Tinel's test [gpnotebook.com]

• Forearm Pain

  Treatments That Provide Forearm Pain Relief Some patients with pronator syndrome can get forearm soreness relief with conservative forearm pain treatment. [indianahandtoshoulder.com]

  A 29-year-old pregnant dentist developed acute right forearm pain and associated weakness in her hand. A diagnosis of pronator syndrome was made. A review of the anatomy, pathophysiology, and treatment of pronator syndrome is given. [ncbi.nlm.nih.gov]

  Median Nerve Injury See Also Internal Hand and Wrist Anatomy (Main) Wrist Pain (Main) Forearm Pain (Main) Elbow Pain (Main) Physical Exam Wrist Neuropathies (Main) External Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist [wikism.org]

  PS is characterized by vague volar forearm pain, with median nerve paresthesias and minimal motor findings. [journals.lww.com]

• Swelling

  As the pain medication leaves your body, you are likely to feel pain and swelling at the treatment site. [drvanessasammons.com.au]

  These include: Bursitis - This is an inflammation and swelling of the fluid filled sac around knee, elbow or shoulder joints. This can occur at the knee, elbow, and shoulder and is called “beat knee”, “beat elbow” or “beat shoulder”. [news-medical.net]

  Localised swelling could cause compression of this nerve against the edge of a forearm muscle (pronator teres muscle). Occasionally, there are thick fibrous bands which could be responsible for the pinching of the nerve. [baur-fromberg.de]

• Surgical Procedure

  I am a Board Certified Orthopedic Surgeon and highly trained in the area of minimally invasive surgical procedures. [handsurgeonorangecounty.com]

  These include: Hand therapy Taking a break from sports and other activities that aggravate the pronator teres muscle Wearing a splint to prevent the forearm from rotating If the symptoms haven’t subsided, a minimally invasive surgical procedure can be [drvanessasammons.com.au]

  The usual surgical procedure is decompression of the nerve entrapment via an anterior approach. Anatomical variants such as a supracondylar process (ligament of Struthers) can also be investigated and decompressed if required. [sportsinjurybulletin.com]

• Muscle Weakness

  […] forearm (6) numbness in the hand (7) usually muscle weakness is absent or minimal (muscle strength preserved) (8) tapping over the median nerve may elicit pain or discomfort (Tinel sign) Electrodiagnostic studies may: (1) be normal (2) show a conduction [meducator3.net]

  Differential diagnosis is based largely on the symptoms, patterns of paresthesia, and specific patterns of muscle weakness. [ncbi.nlm.nih.gov]

  When the pronator teres muscle compresses this nerve, it creates aching in the forearm and wrist, possible muscle weakness, and changes in sensation to the thumb and index finger.3 Pronator teres syndrome is like carpal tunnel syndrome, defined as compression [healthfitchiro.com]

  People with this syndrome experience pain, numbness, and muscle weakness in the forearm and hand. These symptoms are also similar to carpal tunnel syndrome, as it compresses the median nerve at the wrist. [massage-education.com]

  Symptoms of pronator teres syndrome include: Aching pain in the forearm Tenderness over the actual pronator teres muscle Weakness in the arm or hand Numbness and tingling in the palm, thumb or index finger Typically not having pain or discomfort at night [study.com]

• Elbow Pain

  This syndrome may be misdiagnosed as tennis elbow because pain is felt on the outside (lateral) part of the elbow in both of these conditions. [northshore.org]

  Acetaminophen for Treatment of Elbow Pain Acetaminophen for Treatment of Elbow Pain is recommended for the treatment of elbow discomfort, especially in those who have NSAID contraindications. [cortho.org]

  I approach treating your elbow pain to your presentation, which involves: Analyzing your posture – is rotary cuff weakness playing into your pain? Discussing potential lifestyle dynamics impacting the effected the forearm. [ridgefieldacupuncture.com]

  This DVD, Nerve Mobilization teaches massage therapy techniques for clients with elbow pain, as well as many other medical nerve conditions. [massage-education.com]

  Median Nerve Injury See Also Internal Hand and Wrist Anatomy (Main) Wrist Pain (Main) Forearm Pain (Main) Elbow Pain (Main) Physical Exam Wrist Neuropathies (Main) External Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist [wikism.org]

• Osteoporosis

  This edition also provides expanded coverage of molecular orthopaedics, biomaterials, orthotics and prosthetics, diagnosis by physical examination, commonly ordered laboratory tests, rehabilitation, biomechanics, principles of fractures, osteoporosis, [books.google.com]

• Tingling

  The procedure will help with the numbness, tingling, forearm pain, and hand pain. Hand Associates of North Dallas [handassociatesnd.squarespace.com]

  These include: weakness in hand grip strength, numbness/tingling in hands/fingers, numbness/tingling in palmar surface of hand, difficulty pinching together index finger and thumb. [augustpoint.wordpress.com]

  Additionally, if you have Pronator Teres Syndrome you will likely experience more pronounced numbness and/or a tingling sensation in the palm of the hand as opposed to Carpal Tunnel Syndrome in which the more pronounced numbness and/or a tingling sensation [loredohands.com]

  Symptoms of pronator teres syndrome can be very similar to carpal tunnel syndrome and include: Tingling or numbness in the palm, thumb and three fingers but not the little pinky finger. [sportsinjuryclinic.net]

• Paresthesia

  If paresthesia involved the thenar eminence and proximal forearm pain was noted in cases of carpal tunnel syndrome, carpal tunnel syndrome combined with pronator syndrome was considered. [ncbi.nlm.nih.gov]

  Numbness or paresthesia in the proximal volar forearm, as well as numbness or paresthesia in the distribution of the median nerve Potentially compressible areas involve the Struthers ligament and the supracondylar process of the knee vascular leashes, [pulsus.com]

  […] in thumb, index, middle finger and radial half of ring finger as seen in carpal tunnel syndrome in pronator syndrome paresthesias often made worse with repetitive pronosupination should have characteristics differentiating from carpal tunnel syndrome [orthobullets.com]

  Common in the 4th and 5th decades of life Women have higher incidence, as well as those with forearm hypertrophy (athletes) Clinical Features Symptoms Primarily will complain of paresthesia overlying the 1st, 2nd, 3rd and lateral portion of the 4th digit [wikem.org]

  […] factors 5th decade of life 4x more common in women Signs / Symptoms Pain Proximal anterior aspect of forearm Repeated pronation Repeated supination Exertional grasp work Examples: assembly line workers, carpenters, weightlifters, and tennis players Paresthesia [elbowdifferentialdiagnosis.weebly.com]

• Confusion

  Etiology Pathoanatomy 5 potential sites of entrapment include supracondylar process residual osseous structure on distal humerus present in 1% of population ligament of Struthers travels from tip of supracondylar process to medial epicondyle not to be confused [orthobullets.com]

  This pressure has generally been ascribed to hypertrophy of the muscle, although cases of abnormal fibrous bands have been noted. 2 The clinical picture may be confused with that produced by a. .. [nejm.org]

  The two syndromes are therefore often confused. In addition, the two syndromes may occur simultaneously, meaning that the median nerve is compressed in two places at the same time, i.e. a “double crush”. [rearmyourselftexas.com]

  […] actual pronator teres muscle Weakness in the arm or hand Numbness and tingling in the palm, thumb or index finger Typically not having pain or discomfort at night (pain at night is more common with carpal tunnel syndrome) Pronator teres syndrome is often confused [study.com]

• Paresis

  Symptoms and signs include aching in the wrist with a subjective feeling of poor coordination; paresthesias extending into the hand; paresis of the thumb muscles; pain on pronation of the forearm and flexion of the wrist against resistance; and tenderness [medical-dictionary.thefreedictionary.com]

  This compression is characterized by paresis of the wrist flexor muscles or some of the thenar, signs which can add to numbness and pain in the hand. The aim of this study was to describe the relation of the median nerve with the PT muscle. [go.gale.com]

• Hypesthesia

  Individuals with this syndrome are first seen clinically with pain and tenderness in the proximal aspect of the anterior forearm, and hypesthesia (decreased sensation) of palmar aspects of the radial three and half digits and adjacent palm. [curofy.com]

  The most common physical finding was a positive pronator compression test, followed by median nerve hypesthesia. Elbow to wrist nerve conduction tests were obtained in 37 of 39 limbs and were abnormal in 12. [typeset.io]

I wonder if my workup will change afterward. We'll see. [forums.studentdoctor.net]

In contrast to CTS, both magnetic resonance and ultrasonographic imaging are not recommended in a PS workup because of the lack of current clinical evidence [12]. [mdpi.com]

Treatment Options In the event that non-surgical treatment is ineffective, Dr. [loredohands.com]

Proper localization is crucial to treatment options. Surgery can provide benefit in selected cases. [ncbi.nlm.nih.gov]

Operative treatment: Surgical exploration and release of impinging structures. [orthopaedicsone.com]

To our best knowledge, treatment of the pronator teres syndrome by means of botulinum toxine injection still has not been reported in literature. [thieme-connect.com]

Treatment of Pronator Syndrome Nonoperative Treatment For mild to moderate symptom Rest Splinting to avoid forearm rotation NSAIDS The treatment is carried out for 3-6 months. A splint is applied to avoid forearm rotation. [boneandspine.com]

Coverage of each disorder includes more details on treatment and prognosis. [books.google.com]

Prognosis for Pronator Teres Syndrome Prognosis for prospective patients is usually favorable, with many post-operative patients reporting that they became pain-free or had a great reduction of their symptoms. [handsport.us]

Although both proximal median entrapment syndromes have a favorable prognosis when treated non-operatively, the authors recommend operative treatment in cases in which there is no perceptible improvement following 8 weeks of non-operative treatment, since [typeset.io]

Treatment and prognosis Conservative treatment may be effective in 50–70% of cases with extremity rest and non-steroidal anti-inflammatory drugs. Corticosteroids have also been used. [radiopaedia.org]

Fibrous bands from the pronator muscle, encircling the nerve, seemed to be an etiological factor. Eight of nine patients were either improved or recovered completely by surgical treatment. [ncbi.nlm.nih.gov]

Most frequent etiologies include anatomical abnormalities, occasionally manifested by repetitive pronation of the forearm or bearing of heavy loads. The diagnosis is mainly based on the patients history and clinical findings. [thieme-connect.com]

Epidemiology Incidence rare < 1 per 100,000 annually Demographics female > male common in 5th decade Risk factors associated with well-developed forearm muscles (e.g. weight lifters) Etiology Pathoanatomy 5 potential sites of entrapment include supracondylar [orthobullets.com]

#1 39 yo female with 1 year of left arm weakness and numbness, unknown etiology. Not worsening over time. Pain is elbow, forearm and palm, numbness is median nerve and forearm. Strength grossly normal except APB and she cannot bend DIP index. [forums.studentdoctor.net]

Burroughs, MD, CAQSM Reviewed 04/2019 BASICS DESCRIPTION EPIDEMIOLOGY ETIOLOGY AND PATHOPHYSIOLOGY RISK FACTORS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES SURGERY/OTHER PROCEDURES [5minuteconsult.com]

Epidemiology Incidence rare < 1 per 100,000 annually Demographics female > male common in 5th decade Risk factors associated with well-developed forearm muscles (e.g. weight lifters) Etiology Pathoanatomy 5 potential sites of entrapment include supracondylar [orthobullets.com]

Burroughs, MD, CAQSM Reviewed 04/2019 BASICS DESCRIPTION EPIDEMIOLOGY ETIOLOGY AND PATHOPHYSIOLOGY RISK FACTORS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES SURGERY/OTHER PROCEDURES [5minuteconsult.com]

Epidemiology Pronator teres syndrome is a rare condition that may be easily overlooked and mistaken for the more prevalent carpal tunnel syndrome (CTS). [10][11] No age group preference has been described, but one study reports a higher prevalence of [ncbi.nlm.nih.gov]

A review of the anatomy, pathophysiology, and treatment of pronator syndrome is given. We present this case to alert dentists, both male and female, of an uncommon but definite occupational hazard. [ncbi.nlm.nih.gov]

From WikiSM Jump to: navigation, search Contents 1 Other Names 2 Background 3 Pathophysiology 4 Risk Factors 5 Differential Diagnosis 5.1 Differential Diagnosis Wrist Pain 5.2 Differential Diagnosis Forearm Pain 5.3 Other Considerations 6 Clinical Features [wikism.org]

Burroughs, MD, CAQSM Reviewed 04/2019 BASICS DESCRIPTION EPIDEMIOLOGY ETIOLOGY AND PATHOPHYSIOLOGY RISK FACTORS DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES SURGERY/OTHER PROCEDURES [5minuteconsult.com]

My staff and I at the Nebraska Hand & Shoulder Institute, P.C. believe that prevention and elimination of painful or debilitating conditions of the upper and lower extremities can consistently be achieved. [carpaltunnelrelief.net]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

Injury Prevention Prevention is based on avoiding repetitive activities. If this is not possible, the patient should ensure equipment is fitted appropriately. [sportsmedtoday.com]

Preventing Pronator Teres Syndrome Pronator Teres Syndrome may be aggravated or caused by forceful repetitive movements in the forearm. [handsport.us]