Posterior interosseous neuropathy: distinguishing from a proximal radial neuropathy

The posterior interosseous nerve is the terminal motor branch of the radial nerve that innervates the extensor carpi ulnaris and the extensors of the thumb and fingers. We describe a case of a posterior interosseous neuropathy presenting with the typical ‘finger drop’ and partial ‘wrist drop’. We fo...

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Bibliographic Details
Published in:BMJ case reports 2021-10, Vol.14 (10), p.e245659
Main Authors: McKenna, Mary Clare, Woods, Jack, Dolan, Róisín, Connolly, Seán
Format: Article
Language:English
Subjects:
Case Report
Case reports
Data analysis
Electromyography
Fingers & toes
Illustrators
Neurological disorders
Ultrasonic imaging
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Description
Summary:The posterior interosseous nerve is the terminal motor branch of the radial nerve that innervates the extensor carpi ulnaris and the extensors of the thumb and fingers. We describe a case of a posterior interosseous neuropathy presenting with the typical ‘finger drop’ and partial ‘wrist drop’. We focus on the clinical signs that distinguish it from a more proximal radial neuropathy, clarified by nerve conduction studies and needle electromyography. Multimodal imaging of the forearm did not identify a compressive lesion. Persistent symptoms prompted surgical exploration 5 years after initial onset. It identified compression of the posterior interosseous nerve in the region of the arcade of Frohse and leash of Henry. The sites were decompressed and concurrent salvage secondary reconstructive tendon transfers were required in view of the severe axonal loss with minimal chance of functional reinnervation.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-245659