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4 - Examination of the wrist

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

Publisher: Cambridge University Press
Print publication year: 2014

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Wolfe, SW (ed.) Green’s Operative Hand Surgery, 6th edition. Edinburgh: Churchill Livingstone, 2010.Google Scholar
Schmidt-Rohlting, B. et al. Madelung deformity: clinical features, therapy and results. J Pediatr Orthop B 2001;10:344–348.Google Scholar
Angelides, AC, Wallace, PF. The dorsal ganglion of the wrist: its pathogenesis, gross and microscopic anatomy, and surgical treatment. J Hand Surg (Am) 1976;1:228–235.CrossRefGoogle ScholarPubMed
Sanders, WE. The occult dorsal carpal ganglion. J Hand Surg (Br) 1985;10B:257–260.CrossRefGoogle Scholar
The Carpal Boss. Review of diagnosis and treatment. J Hand Surg (Am) 2008;33:446–449.CrossRef
Grundberg, AB, Reagan, DS. Pathological anatomy of the forearm: intersection syndrome. J Hand Surg (Am) 1985;10:299–302.CrossRefGoogle ScholarPubMed
Finkelstein, H. Stenosing tendovaginitis of the radial styloid process. J Bone Joint Surg (Am) 1930;12A:509–540.Google Scholar
Watson, HK, Ashmead, D, Makhlouf, MV. Examination of the scaphoid. J Hand Surg (Am) 1988;13A:657–660.CrossRefGoogle Scholar
Lane, LB. The scaphoid shift test. J Hand Surg (Am) 1993;18A:366–368.CrossRefGoogle Scholar
Cooney, W (ed.) The Wrist: Diagnosis and Operative Treatment, 2nd edition. Philadelphia: Lippincott Williams & Wilkins, 2010.Google Scholar
Easterling, KJ, Wolfe, SW. Scaphoid shift in the uninjured wrist. J Hand Surg (Am) 1994;19A:604–606.CrossRefGoogle Scholar
Feinstein, WK, Lichtman, DM, Noble, PC, Alexander, JW, Hipp, JA. Quantitative assessment of the midcarpal shift test. J Hand Surg (Am) 1999;24A:977–983.CrossRefGoogle Scholar
Tubiana, R, Thomine, J, Mackin, E. Examination of the Hand and Wrist. London: Martin Dunitz, 1998.CrossRefGoogle Scholar
Stanley, J, Saffar, P. Wrist Arthroscopy. London: Martin Dunitz, 1994.Google ScholarPubMed
Nakamura, R, Horii, E, Imaeda, T, et al. The ulnocarpal stress test in the diagnosis of ulnar-sided wrist pain. J Hand Surg (Br) 1997;22B:719–723.CrossRefGoogle Scholar
Sammer, DM, Rizzo, M. Ulnar impaction. Hand Clin 2010;26:549–557.CrossRefGoogle ScholarPubMed
Sachar, K. Ulnar sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg (Am) 2008;33:1669–1679.CrossRefGoogle ScholarPubMed
Reagan, DS, Linscheid, RL, Dobyns, JH. Lunotriquetral sprains. J Hand Surg (Am) 1984;9A:502–514.CrossRefGoogle Scholar
Christodoulou, L, Bainbridge, LC. Clinical diagnosis of triquetrolunate ligament injuries. J Hand Surg (Br) 1999;24B:598–600.CrossRefGoogle Scholar
Hildreth, DH, Breidenbach, WC, Lister, GD, Hodges, AD. Detection of submaximal effort by use of the rapid exchange grip. J Hand Surg (Am) 1989;14A:742–745.CrossRefGoogle Scholar

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