Intersection Syndrome in a Division I Women’s Softball Player : a Case Study

Objective: To present a case report on Intersection Syndrome in a Division I college athlete. Background: An 18-year old female National Collegiate Athletic Association (NCAA) Division I women’s softball player suffered a sudden onset of left wrist pain during a team strength and conditioning workout. Symptoms at the time of injury included pain and decreased active and passive range of motion. Differential Diagnosis: Based on the mechanism and symptoms, several differential diagnoses were considered including De Quervain’s Syndrome, tenosynovitis, Wartenberg’s Syndrome, ganglion cysts, and midcarpal instability. Treatment: The patient was removed from participation and the injured region was immobilized in a removable thumb spica brace. Subsequent to her first physician visit 1 day post-injury, conservative treatment consisting of range of motion (ROM) and strengthening exercises of the forearm, wrist, and hand was initiated. Two corticosteroid injections for the injured wrist were completed at seven and twenty-eight weeks postinjury, both of which provided relief of pain and paresthesia. After a 12-week course of therapeutic interventions and activity modification, the patient was cleared for full sport participation and has experienced no recurrence of symptoms. Uniqueness: Intersection Syndrome is an overuse injury that typically does not present itself after an acute mechanism as presented in this case. Normal recovery time after conservative treatment is commonly 2-3 weeks; this patient required 12 weeks of conservative treatment and activity modification before experiencing symptom relief. Intersection Syndrome is typically diagnosed via MRI, which normally shows increased swelling at the intersection of the first and second compartments of the forearm. Uncharacteristically, swelling was not apparent on the MRI in this case. Conclusion: Intersection syndrome is a rare inflammatory condition commonly due to repetitive, overuse injuries. Sixty percent of individuals with Intersection Syndrome will respond to non-surgical treatment with 2-3 weeks