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Dr. Ebraheim’s educational animated video describes the condition of intersection syndrome. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Intersection syndrome is a painful tenosynovitis involving the tendons of the extensor carpi radialis longus and extensor carpi radialis brevis. There are six extensor compartments of the wrist. The pathology occurs due to stenosis of the second dorsal wrist compartment. The intersection syndrome is an overuse injury caused by repetitive wrist extension with pronation and supination. Intersection syndrome can occur in weight lifting, rowing, and in racket sports. The area of pain and tenderness is located at the intersection between the muscles of the abductor pollicis longus and extensor pollicis brevis, as these two muscles cross over the tendons of the extensor carpi radialis longus and brevis. The patient may describe a squeaking sensation with wrist motion. This intersection syndrome is sometimes called the squeakers wrist or the cross over tendonitis. When the first and second dorsal wrist compartments pass over each other, it will result in inflammation, muscle changes, fibrosus and squeaking during wrist motion. These findings along with the site and location of the pain over the dorsal forearm and wrist, which is about 5 cm distal to the wrist joint, helps to differentiate De Quervain's Syndrome from Intersection Syndrome. When the first dorsal wrist compartment tendons cross over the second compartment structures, the tenderness is palpated at the dorsoradial forearm, approximately 5 cm proximal to the wrist joint. PROVOCATIVE TEST The pain gets worse with resisted wrist extension and the x-ray will not show you anything. You will feel crepitus over the area with resisted wrist extension and thumb extension. RADIOLOGY MRI will probably show you edema or fluid surrounding the first and the second extensor compartments. TREATMENT Rest. Wrist splinting. Steroid injection (perhaps). Try to inject the second dorsal compartment. Ultrasound guided injection may be helpful. Surgery Done as a last resort. Release the second dorsal compartment about 5 - 6 cm proximal to the wrist joint.