Causes / typical injury mechanism: Wartenberg syndrome, also known as cheiralgia paresthetica, is an uncommon syndrome caused by entrapment of the superficial radial nerve, usually between the extensor carpi radialis longus and the brachioradialis in the distal third of the forearm. Repetitive supination / pronation and wrist flexion can cause the nerve to become compressed between the 2 muscles. This can be exacerbated by wearing an accessory around the wrist such as a watch or bracelet.

Classic history and presentation: The classic patient is a woman who wears a bracelet, watch, or hair tie around the wrist and presents with sensory-only changes along the dorsal thumb and index finger and pain in the distal forearm. Symptoms worsen when wearing an accessory on the wrist or due to repetitive wrist motion such as flexion and ulnar deviation. No motor symptoms should be present.

Prevalence:

• Age – This is usually seen in individuals aged 20 years or older.
• Sex / gender – A higher ratio of women to men have this syndrome.

Risk factors:

• Wearing wrist accessories
• Too-tight handcuffs
• Frequent pronation of the wrist
• de Quervain tenosynovitis (may be seen in up to 50% of patients)

Pathophysiology: Entrapment of the superficial radial nerve between the extensor carpi radialis longus and the brachioradialis in the distal third of the forearm causes sensory changes. This syndrome can also be caused by external compression.