Radial Tunnel Syndrome in a Collegiate Baseball Pitcher: A Case Report

Abstract

A Division I baseball pitcher presented with chronic forearm pain in his throwing arm while pitching. Physical examination was remarkable for point tenderness over the radial tunnel. A postexertion magnetic resonance imaging (MRI) scan revealed edema around the posterior interosseous nerve. The patient underwent decompression of the nerve along with radial tunnel release, which resulted in full resolution of symptoms and return to full baseball activities. Radial tunnel syndrome is a rare phenomenon but can occur in throwing athletes. MRI immediately after a pitching session aided in accurate diagnosis and successful surgical management.

Keywords: lateral arm pain; nerve; pitching; radial tunnel syndrome.

Figure 1.

The radial nerve with its major branches including the posterior interosseous nerve. Figure reproduced with permission from Morrey and Sanchez-Sotelo.

Figure 2.

T2 axial MRI scan of the forearm after pitching to maximum symptoms. Edema is noted in the supinator (black translucent arrow) and mild increased T2 signal around the PIN (white solid arrow). The skin marker for the site of pain is present just dorsal to the radial tunnel (white translucent arrow). MRI, magnetic resonance imaging; PIN, posterior interosseous nerve.