Dr. Ebraheim’s educational animated video is the Part 2 educational video describing conditions of the wrist which may cause pain.
Radial wrist pain
De Quervain’s syndrome
Inflammation of the sheath or tunnel that surrounds the two tendons that control movement of the thumb. Pain and swelling over the thumb side of the wrist and difficulty gripping.
Activites that may cause De Quervain’s syndrome
•Twisting/wringing out wet towels
•Hammering
•Skiing
•Lifting heavy objects
•People who care for babies and young children commonly experience De Quervain’s tenosynovitis due to holding or carrying of the child.
Finkelstein’s test is used to diagnose De Quervain’s tenosynovitis in patients who have wrist pain. The Finkelstein test is conducted by making a fist with the fingers closed over the thumb and the wrist is bent toward the little finger. the wrist is then pulled so that the tendons of the first dorsal compartment are stretched distally causing sharp local pain if tendon inflammation is present.
Intersection syndrome
The pain from intersection syndrome is felt on the top of the forearm, where two muscles that connect to the thumb cross over the underlying wrist tendons.
Activities/ motions that may cause intersection syndrome include:
•Overuse of the wrist and hand
•Grasping
•Turning
•Twisting
Ganglion cyst
•Most commonly occurs on the back of the hand at the wrist joint. A small ganglion is usually painful.
•Can arise from the capsule of the wrist joint or from the sheath of the tendons.
Extensor tenosynovitis
•Irritation of the tendons located in the fourth extensor compartment. Difficult to diagnose due to complex anatomy and biomechanics.
Triangular fibrocartilage (TFCC)
•The triangular fibrocartilage complex works as a cushion that stabilizes the wrist joint.
•Injury or degeneration of the TFCC can lead to a wrist sprain or a very disabling wrist condition.
Symptoms of TFCC include:
•Swelling
•Clicking
•Snapping/cracking
•Weakness
Diagnosis includes
•Physical examination
•MRI
•Wrist Arthroscopy
Treatment includes
•Anti-inflammatory medication
•Physical therapy
•Injections
•Debridement or repair of complex tear.
Extensor carpi ulnaris subluxation or inflammation
•Snapping ECU syndrome is a condition due to extensor carpi ulnaris tendon sliding in and out of its groove.
•If the ECU tendon is not held in place, it may “snap” over the bone as the wrist is rotated causing tendonitis of the ECU tendon.
Distal radioulnar joint
•Arthritis or trauma
•May arise from various sources such as repetitive injury or previous trauma.
•Degenerative arthritis is usually post-traumatic.
•Inflammatory arthritis includes conditions such as rheumatoid.
