Wartenberg's syndrome

Compression of the superficial radial nerve in the forearm, causing burning pain, tingling or numbness over the back of the thumb and hand that is worse with wrist movement. It can coexist with De Quervain's tenosynovitis and should be recognised before the first extensor compartment is released. It is different from Wartenberg's sign, a finding in ulnar nerve palsy.

Related terms

• Anatomy

  Superficial radial nerve

  The sensory branch of the radial nerve that runs under the skin of the forearm to supply feeling over the back of the thumb and the web space. Its branches often cross the first extensor compartment, so they are protected during surgery there; handling them can cause temporary tingling, and injury can leave numbness or a painful neuroma.

• Condition

  De Quervain's tenosynovitis

  Painful thickening of the first extensor compartment at the wrist, so that the abductor pollicis longus and extensor pollicis brevis tendons no longer glide freely. It causes pain over the thumb side of the wrist on gripping and pinching, is commoner in women, after 40 and around pregnancy, and is treated with a splint, a steroid injection or, if these fail, surgical release.

• Investigation

  Wartenberg's sign

  Persistent abduction of the little finger with inability to adduct it actively to the ring finger, seen in ulnar nerve palsy: the unopposed extensor and abductor digiti minimi abduct the finger while the weak third palmar interosseous cannot bring it back. It is also seen during ulnar nerve regeneration, occurs rarely without a neuropathy, and is distinct from Wartenberg's syndrome, the compression of the superficial radial nerve.

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