Compression of the posterior interosseous nerve due to an occult ganglion cyst in the elbow of an amateur pianist

The continued growth of recreational and professional instrument playing is accompanied by the need for health care providers who can recognize and treat conditions in musicians that have traditionally been associated with other occupational injuries. This is particularly important when early diagnosis and prompt intervention may alter the outcome. We present an interesting case of paralysis of the posterior interosseous nerve caused by a ganglion at the arcade of Frohse (supinator arch) in close proximity to the extensor carpi radialis brevis. The patient was an amateur pianist who developed the ganglion after intensive piano practice for 3 months The patient experienced complete pain relief with full preservation of function after treatment. We review the evaluation, diagnosis, biomechanical pathogenesis, and current treatment algorithms.