TRIANGULAR INTERVAL SYNDROME (TIS)

Stefan Duell

2020/01/07

SHOULDER OR ARM PAIN?

The Triangular Interval (also known as the lateral triangular space, lower
triangular space and triceps hiatus) is a space connecting the axilla to
the posterior compartment of the arm. It is one of the three intermuscular
spaces found in the axillary space. The other two spaces are
Quadrangular Space and Triangular Space.

Triangular Interval (4)

Borders
▪️superior: teres major
▪️lateral: lateral head of the triceps or the humerus
▪️medial: long head of the triceps
Contents
▪️profunda brachii artery
▪️radial nerve
⠀
Quadrangular Space (5)
Borders
▪️medial: long head of triceps
▪️lateral: humeral shaft
▪️superior: teres minor
▪️inferior: teres major
Contents
▪️axillary nerve
▪️posterior humeral circumflex artery
⠀
Triangular Space (3)
Borders
▪️inferior: teres major
▪️lateral: long head of triceps
▪️superior: lower border of teres minor
Contents
▪️scapular circumflex artery
⠀

Triangular Interval Syndrome (TIS) was described as a differential

diagnosis for radicular pain in the upper extremity.
It is a condition where the radial nerve is entrapped in the triangular
interval resulting in upper extremity radicular pain.

The radial nerve and profunda brachii pass through the triangular interval
and are hence vulnerable. The triangular interval has a potential for
compromise secondary alterations in thickness of the teres major and
triceps. It is described based on cadaveric studies that fibrous bands
were commonly present between the teres major and triceps. When
these bands were present, rotation of the shoulder caused a reduction in
cross sectional area of the space.

Hypertrophy of the teres major can occur secondary to weight training

and potentially compromise the triangular interval with resultant
entrapment of the radial nerve.

Shoulder dysfunctions have a potential for shortening and hypertrophy of

the teres major.

The triceps brachii has a potential to entrap the radial nerve in the
triangular interval secondary to hypertrophy. The presence of a fibrous
arch in the long head and lateral head further complicates the situation.

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