Radial tunnel syndrome

    -  same nerve is being compressed in the same location in RTS.    only pain, discomfort and 
       inability to perform routine tasks   that is the presenting complaint.   no motor weakness.

    -  large myelinated fiber(group IIB),  unmyelinated(group IV, c-fiber), small myelinated(group IIa)

    *  symptoms and signs

              -  pain distal to lateral epicondyle, tenderness over  radial tunnel along the path of PIN, 
                  moble wad

              -  pain worsened by extending elbow, pronating forearm and flexing  wrist

              -  pain with resisted active supination or wrist extension

              -  pain with active supination against resistance

              -  pain with resisted middle finger extension at metacarpophalangeal joint, induce cocontraction  of ECRB

    *  neurological deficit,  local tenderness at mobile wad

    *  pain disappears after instilling local anaesthetic at the site of entry of PIN

    *  Electrodiagnostic studies : normal 

    *  differential diagnosis: lateral epicondylitis, osteoarthritis of radial capitellar joint, 
                    impingement of the articular branch of the  radial nerve, 
                     muscle tear of the extensor carpi radialis brevis

     *  management

            -  conservative : rest and splinting, avoid provocative postures, injection of local steroids 
                                    with or without local anaesthetic

            -  surgical decompression