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4 - Examination of the wrist

Stephen Bostock
Affiliation:
Sheffield Teaching Hospitals NHS Foundation Trust
Nick Harris
Affiliation:
Department of Orthopaedic Surgery, Leeds General Infirmary
Fazal Ali
Affiliation:
Department of Orthopaedic Surgery, Chesterfield Royal Hospital
Mark D. Miller
Affiliation:
James Madison University, Virginia
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Summary

History

Patients with wrist problems often have a paucity of clinical signs. Specific provocative tests can be both difficult to perform and equivocal in their interpretation. A thorough history is therefore essential.

The history should start by recording the age, occupation and handedness of the patient, together with any affected recreational activities, including sports and hobbies.

The basic complaint needs to be established. Is it pain, weakness, a swelling, stiffness or a combination of these? Are there other symptoms? How long has there been a problem? Was there an injury or has the onset been insidious? What was the nature of the injury; was it a single event and, if so, did it receive treatment at the time?

The site and nature of pain should be established (Figure 4.1). The patient should be asked to try to localize it as accurately as possible (for example, by pointing). What is its nature; is it constant or intermittent, sharp, dull or ‘burning’? Is it worse with use and eased by rest? Are there particular movements that aggravate the pain such as turning taps, opening jars?

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Publisher: Cambridge University Press
Print publication year: 2014

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