Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2023; 11(27): 6624-6630
Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6624
Treatment of posterior interosseous nerve entrapment syndrome with ultrasound-guided hydrodissection: A case report
Lan-Hui Qin, Wan Cao, Fei-Tong Chen, Qi-Bo Chen, Xi-Xia Liu
Lan-Hui Qin, Wan Cao, Fei-Tong Chen, Qi-Bo Chen, Xi-Xia Liu, Department of Rehebalitation Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Qin LH was a major contributor in writing the manuscript; Cao W, Chen QB, and Chen FT analyzed and interpreted the patient data; Liu XX presented information and contributed to editing and revision of the article; All authors approved submission of the manuscript.
Supported by the Guangxi Natural Science Foundation, No. 2022GXNSFBA035519; and No. 2023GXNSFAA026175; Self-funded Project of Guangxi Health Commission, No. Z20180776 and No. Z20210179; and Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project, No. S2020081.
Informed consent statement: Informed written consent was obtained from the patient’s parents for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xi-Xia Liu, PhD, Doctor, Department of Rehebalitation Medicine, The People's Hospital of Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. liuxixia2008@126.com
Received: July 5, 2023
Peer-review started: July 5, 2023
First decision: August 10, 2023
Revised: August 20, 2023
Accepted: September 6, 2023
Article in press: September 6, 2023
Published online: September 26, 2023
Processing time: 77 Days and 16 Hours
Abstract
BACKGROUND

Posterior interosseous nerve (PIN) entrapment syndrome is one of the causes of weakness and pain of the arm muscles, which is prone to missed diagnosis and misdiagnosis in clinic practice. This paper reports a case of PIN entrapment syndrome, with PIN injury indicated by electrophysiology. Musculoskeletal ultrasound was applied to identify that the entrapment point was located at the inlet of the Frohse arch and the outlet of the supinator muscle. Treatment with ultrasound-guided nerve hydrodissection was performed on the entrapment point, which significantly improved the symptoms. Ultrasound-guided nerve hydrodissection is an effective therapeutic method for PIN entrapment syndrome.

CASE SUMMARY

A male patient, 35 years old, worked as an automobile mechanic. He felt slightly weak extension activity of his right fingers 2 years ago but sought no treatment. Later, the symptoms gradually became aggravated and led to finger drop, particularly severe in the right middle finger, accompanied by supination weakness of the right forearm. Neural electrophysiological examination showed that the patient had partial PIN injury of the right radius. Musculoskeletal ultrasound examination indicated PIN entrapment at the inlet of the Frohse arch and the outlet of the supinator muscle. Therefore, PIN entrapment syndrome was diagnosed. After treatment with ultrasound-guided nerve hydrodissection around the entrapment point, the dorsiflexion weakness of the right hand was significantly improved compared with before treatment.

CONCLUSION

Ultrasound-guided hydrodissection is efficacious for PIN entrapment syndrome, with high clinical value and great application prospects.

Keywords: Ultrasound-guided injection; Nerve hydrodissection; Posterior interosseous nerve entrapment syndrome; Radial nerve; Case report

Core Tip: Posterior interosseous nerve (PIN) entrapment syndrome, a cause of weakness and pain of the arm muscles, can be easily missed and misdiagnosed. This paper reports a case of PIN entrapment syndrome in which the PIN entrapment was located at the supinator muscle, according to the diagnosis by ultrasound. The entrapment point was treated with ultrasound-guided nerve hydrodissection, which had good efficacy, making this an option for the treatment of PIN entrapment syndrome.