Our Summary

This research paper discusses a medical procedure known as arthroscopy of the distal radioulnar joint (DRUJ), which is a joint in the wrist. The purpose of this operation is to visually inspect certain parts of the wrist joint to diagnose and treat pain on the ulnar side (the side of the wrist near the pinky finger).

This procedure is typically used when standard X-rays and MRIs have not been able to identify the cause of the wrist pain. During the operation, two openings are created on the back side of the wrist. A small camera called an arthroscope is then inserted through these openings to inspect the joint.

However, the study notes that this procedure is not commonly performed and requires a high level of technical skill. It can be challenging due to the complex anatomy of the wrist, and a full view of the joint is not always achievable. There is also a risk of rare complications, such as injuries to a specific tendon, or damage to a branch of the ulnar nerve.

Despite these challenges, the procedure can be valuable in certain cases. It is especially useful for detecting injuries to the triangular fibrocartilage complex (a structure in the wrist that helps with stability and shock absorption), which might otherwise go unnoticed.

FAQs

  1. What is the purpose of arthroscopy of the distal radioulnar joint (DRUJ)?
  2. What are the possible complications of a wrist arthroscopy?
  3. When is wrist arthroscopy typically used in diagnosing wrist pain?

Doctor’s Tip

A helpful tip a doctor might tell a patient about wrist arthroscopy is to follow post-operative instructions carefully, including keeping the wrist elevated, applying ice, and attending physical therapy as recommended. It is important to communicate any unusual symptoms or concerns to the doctor to ensure proper healing and recovery.

Suitable For

Patients who may be recommended wrist arthroscopy include those with persistent wrist pain on the ulnar side, suspected triangular fibrocartilage complex injuries, or other conditions that have not been identified through other imaging techniques. Additionally, patients who have tried conservative treatments without success may also be candidates for this procedure.

Overall, wrist arthroscopy may be recommended for patients who have specific symptoms and conditions that warrant further investigation and potential treatment. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if wrist arthroscopy is the right course of action for their individual situation.

Timeline

Before wrist arthroscopy:

  1. Patient experiences persistent wrist pain that has not been diagnosed through standard imaging techniques.
  2. Patient consults with a doctor who recommends wrist arthroscopy as a diagnostic and potentially therapeutic procedure.
  3. Pre-operative consultations and tests are conducted to ensure the patient is a suitable candidate for the procedure.
  4. Patient receives information about the risks and benefits of wrist arthroscopy and gives informed consent for the operation.

After wrist arthroscopy:

  1. Patient undergoes the arthroscopic procedure under anesthesia.
  2. Post-operatively, the patient may experience some pain, swelling, and stiffness in the wrist, which can be managed with pain medication and physical therapy.
  3. The patient is advised to rest and avoid strenuous activities for a period of time to allow the wrist to heal properly.
  4. Follow-up appointments are scheduled to monitor the patient’s recovery and address any concerns or complications that may arise.
  5. In some cases, the wrist arthroscopy may lead to a diagnosis of a specific condition or injury, allowing for targeted treatment to be initiated.

What to Ask Your Doctor

Some questions a patient should ask their doctor about wrist arthroscopy include:

  1. What are the specific reasons for recommending wrist arthroscopy in my case?
  2. What are the potential risks and complications associated with this procedure?
  3. How experienced are you in performing wrist arthroscopy?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. Are there any alternative treatment options available for my condition?
  6. Will I need any additional imaging or tests before the procedure?
  7. How long will the procedure take, and will it be done under general anesthesia or local anesthesia?
  8. What are the expected outcomes of the surgery in terms of pain relief and functionality of the wrist?
  9. How long will I need to take off work or restrict certain activities after the surgery?
  10. Are there any specific post-operative care instructions or exercises I should follow?

Reference

Authors: Pillukat T, Mühldorfer-Fodor M, Windolf J, van Schoonhoven J. Journal: Orthopade. 2018 Aug;47(8):647-654. doi: 10.1007/s00132-018-3582-z. PMID: 29797018