Symptoms

The main symptom of Supinator Lodge Syndrome is a weakness in finger extension. The weakness can develop to the point where the fingers can no longer be stretched at all. It is important to note that this is a purely motor problem, since only the motor part of the radial nerve is affected in Supinator Lodge Syndrome.

The sensitive part is completely intact, so there is no disturbance of sensation in the fingers or arms. Additional impairment of sensitivity gives an indication of an injury to the radialis nerve before it splits into its motor and sensitive parts. Such an injury would then lie in the direction of the upper arm.

However, the back of the hand can be raised all the time, unlike the fingers. So there are only “falling fingers”, so to speak, and no “falling hand”. Another symptom of the supinatorlogen syndrome is a so-called load-dependent pain in the area of the outer elbow joint.

This is where the so-called radius head is located, which is a sphere-like structure of the radius bone. The pain occurs mainly during rotational movements, i.e. when the patient turns the palm upwards. It is possible that repeated rotary movements of the forearm can cause a feeling of muscle fatigue.

This feeling is familiar from repeating the same exercise several times in sports. The patient may also experience pain in the Supinator Lodge Syndrome that radiates to the wrist of the affected side.In Supinator Lodge Syndrome there is pain that most people describe as “dull”. They often occur spontaneously and are mainly found in the area of the lower arm below the elbow.

Pressure on the affected area increases the pain. Occasionally, the pain can also appear along the forearm to the wrist. This depends on the extent of the nerve damage.

In the case of the supinatorlogen syndrome, only the lower part of the arm is affected, since the nerve damage also occurs only on the forearm. The resulting symptoms therefore only affect the forearm, not the upper arm. Since the supinatorlogen syndrome only affects the motor fibers of the radialis nerve on the arm, there are no sensory disorders on the arm.

Damage to the motor nerve fibers results in weakness of finger insertion and pain when the forearm rotates. In supinatorlogenous syndrome, damage (lesion) occurs in a partial area of the radialis nerve (the so-called ramus profundus, literally “deep branch”). As a result, when this nerve is completely severed, the muscles supplied by the nerve responsible for the extension of the third and fourth fingers can suddenly no longer be used properly.

It also results in a rather dull pain. In tennis elbow, on the other hand, incorrect or even excessive strain can cause minor injuries in the area of the muscle attachments at the elbow, resulting in severe pain. The muscles are still functioning at first and can only be actively moved to a lesser extent as the disease progresses.

The diagnosis of Supinator Lodge Syndrome consists of the patient’s medical history and physical examination. This can provide a first impression of where the cause of the problem may be found. Next, a nerve specialist (neurologist) can determine the conduction velocity of the affected nerve.

If pressure causes significant damage to the nerve sheath and the nerve, its conduction velocity can be significantly reduced. Ultrasound examinations and other imaging procedures such as X-rays or MRIs can also be used to make a diagnosis. Ultrasound can detect possible lipomas (fat tumors) or ganglia (benign soft tissue tumors), which lead to constant pressure on the nerves.

X-ray examinations can exclude possible fractures of the ulna and radius. The MRI of the elbow and forearm can be used as a component in diagnostics. Its primary purpose is to show constricting structures. For example, MRI images can show bruises, inflammations or even small fat tumors that squeeze the radial nerve. However, damage to nerve function or the radial nerve itself cannot be depicted by MRI.