Radial tunnel syndrome (RTS) is caused by increased pressure on the radial nerve as it travels from the upper arm (the brachial plexus) to the hand and wrist. Symptoms and signs
Radial tunnel syndrome causes posterolateral elbow pain that is similar to tennis elbow and may sometimes occur in conjunction with that condition. Patients may typically have weakness of extension at the wrist and third digit. The pain is often reproduced upon resisted supination of the forearm, and pain at the radial tunnel on resisted hyperextension of the wrist. Cause
The theory is that the radial nerve becomes irritated and/or inflamed from friction caused by compression by muscles in the forearm.Some speculate that radial tunnel syndrome is a type of repetitive strain injury (RSI), but there is no detectable pathophysiology and even the existence of this disorder is questioned.The term "radial tunnel syndrome" is used for compression of the posterior interosseous nerve, a division of the radial nerve, at the lateral intermuscular septum of arm, while "supinator syndrome" is used for compression at the arcade of Frohse.The "radial tunnel" is the region from the humeroradial joint past the proximal origin of the supinator muscle. Some scientists believe the radial tunnel extends as far as the distal border of the supinator. The radial nerve is commonly compressed within a 5 cm region near the elbow, but it can be compressed anywhere along the forearm if the syndrome is caused by injury (e.g. a fracture that puts pressure on the radial nerve).
Miltefosine, sold under the trade name Impavido among others, is a medication mainly used to treat leishmaniasis and free-living amoeba infections such as Naegleria fowleri and Balamuthia mandrillaris. This includes the three forms of leishmaniasis: cutaneous, visceral and mucosal. It may be used with liposomal amphotericin B or paromomycin. It is taken by mouth.Common side effects include vomiting, abdominal pain, fever, headaches, and decreased kidney function. More severe side effects may include Stevens–Johnson syndrome or low blood platelets. Use during pregnancy appears to cause harm to the baby and use during breastfeeding is not recommended. How it works is not entirely clear.Miltefosine was first made in the early 1980s and studied as a treatment for cancer. A few years later it was found to be useful for leishmaniasis and was approved for this use in 2002 in India. It is on the World Health Organizations List of Essential Medicines. Medical uses
Leishmaniasis
Miltefosine is primarily used for the treatment of visceral and New World cutaneous leishmaniasis, and is undergoing clinical trials for this use in several countries. This drug is now listed as a core medication for the treatment of leishmaniasis under the WHO Model List of Essential Medicines. Several medical agents have some efficacy against visceral or cutaneous leishmaniasis, however, a 2005 survey concluded that miltefosine is the only effective oral treatment for both forms of leishmaniasis.