Case discussion: 18-year old female tennis player with progressing dorsal forearm pain

An 18-year-old female tennis player presents with a complaint of pain 2 inches or so above the wrist on the dorsoradial aspect.  The problem beganapproximately 2 months ago as the player was ramping up her training program in preparation for competition.   To date treatment had consisted of ultrasound, IFC, and splinting with an accompanying diagnosis of “tendinitis.”

Manual muscle testing of the patient’s forearm and hand muscles was unremarkable, as were the results of range of motion and orthopedic testing.  Tendon palpation of the surrounding area failed to reproduce pain.  However it was noted that palpation of the area of complaint a ‘creaking’ sensation was noted along with increased tissue tension with movement of the wrist into flexion and extension.  Tissue tension was further increased with passive movement of the first three digits.  No visible swelling or bruising was noted.

Please suggest differentials, and discuss.

Case answer and condition review to be posted in 2 days time.

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