Our Summary

This research paper discusses the difficulties in diagnosing the cause of pain on the inner side of the wrist, which can be either sudden or long-term. Possible causes include injuries to the wrist bones on the pinky-finger side, torn ligaments, inflammation of the tendons, blood vessel conditions, types of arthritis, and pressure on the inner wrist nerve. The paper suggests that a thorough physical examination based on the anatomy of the wrist, along with certain tests that provoke a response from the wrist, can help identify the cause of the pain. The paper also discusses the use of medical imaging techniques, such as X-rays and MRI scans, in diagnosing this type of wrist pain. It highlights the growing importance of wrist arthroscopy (a minimally invasive procedure that allows doctors to examine the wrist joint) in both diagnosing and treating inner wrist pain caused by issues within the wrist joint.

FAQs

  1. What is ulnar-sided wrist pain and what could potentially cause it?
  2. What diagnostic imaging is used in the evaluation of ulnar-sided wrist pain?
  3. How is wrist arthroscopy used in the diagnosis and management of ulnar-sided intra-articular wrist pathology?

Doctor’s Tip

A doctor may advise a patient considering wrist arthroscopy to:

  • Ensure they have a thorough understanding of the procedure and its potential benefits and risks.
  • Follow any preoperative instructions carefully, including fasting before the procedure.
  • Plan for adequate rest and recovery time post-surgery.
  • Attend all follow-up appointments and adhere to any physical therapy or rehabilitation recommendations.
  • Report any unusual symptoms or concerns to their healthcare provider promptly.

Suitable For

Patients who are typically recommended wrist arthroscopy are those who have ulnar-sided wrist pain that is not responding to conservative treatment, such as rest, physical therapy, and anti-inflammatory medications. These patients may have a suspected injury to the ulnar carpal bones, ligament tears, tendinitis, osteoarthritis, or other intra-articular pathologies that cannot be definitively diagnosed with imaging alone. Wrist arthroscopy allows for direct visualization of the wrist joint, enabling the surgeon to diagnose and treat the underlying cause of the patient’s symptoms. It is a minimally invasive procedure that can lead to quicker recovery times and better outcomes for patients with ulnar-sided wrist pain.

Timeline

Before wrist arthroscopy:

  1. Patient experiences ulnar-sided wrist pain, which may be acute or chronic.
  2. Differential diagnoses are considered, including injuries to the ulnar carpal bones, ligament tears, tendinitis, vascular conditions, osteoarthritis, systemic arthritis, and ulnar nerve compression.
  3. An anatomically based physical examination is conducted, along with provocative maneuvers to further define the differential diagnosis.
  4. Diagnostic imaging such as plain radiographs and MRI with or without arthrography may be used to evaluate the condition.

After wrist arthroscopy:

  1. Wrist arthroscopy is performed to diagnose and manage ulnar-sided intra-articular wrist pathology.
  2. The surgeon may repair any tears or injuries found during the procedure.
  3. Recovery and rehabilitation are initiated to restore function and alleviate pain.
  4. Follow-up appointments are scheduled to monitor progress and ensure proper healing.
  5. Physical therapy may be recommended to aid in recovery and strengthen the wrist.

What to Ask Your Doctor

  1. What specific condition or injury are you looking for with the wrist arthroscopy?
  2. What are the potential risks and complications of the procedure?
  3. How long does the recovery process typically take after wrist arthroscopy?
  4. Will I need physical therapy or rehabilitation after the procedure?
  5. What are the expected outcomes or benefits of undergoing wrist arthroscopy?
  6. Are there any alternative treatments or procedures that could be considered for my condition?
  7. How many wrist arthroscopy procedures have you performed, and what is your success rate?
  8. Will I need to undergo any additional tests or imaging before the wrist arthroscopy?
  9. How long will the procedure take, and will I be under general anesthesia or sedation?
  10. Are there any specific post-operative instructions or restrictions that I should be aware of?

Reference

Authors: DaSilva MF, Goodman AD, Gil JA, Akelman E. Journal: J Am Acad Orthop Surg. 2017 Aug;25(8):e150-e156. doi: 10.5435/JAAOS-D-16-00407. PMID: 28737618