Wrist pain may be caused by arthritis, tendonitis, synovitis (inflammation inside the joint) or after a sprain. Most of the time the combination of examination and xray will reveal what is the source of discomfort. Pain from a wrist sprain may actually reflect a partial or complete ligament tear. Alternatively you may have a small ganglion cyst inside the joint or simple scar tissue that can cause impingement type pain with wrist extension.

I will often begin treatment with conservative measures, which include a splint for immobilization, and, at times, a cortisone shot.

If pain persists more than 8- 12 weeks,and interferes with activities, however, the next step may include a diagnostic wrist arthroscopy.

Though the natural history of a ligament injury is that 50% may heal by 1 year, quicker recovery is possible with earlier intervention-- to debride a partial tear, remove synovitis, remove a ganglion cyst or to fix a complete tear. MRI scans are not always diagnostic and can be falsely negative, so if I suspect a ligament tear or ganglion, and it does not get better, I will often not recommend an MRI and proceed directly to wrist arthroscopy, since it allows me to both definitively diagnose and treat your problem. Below you will find 3 videos of various parts of a diagnostic wrist arthroscopy.

The most commonly injured ligaments in the wrist are the scapholunate (SL) ligament --pain is on the top of the wrist--, and the TFCC and LT ligaments--pain is on the outside of the wrist (see my article on ulnar wrist pain).

Surgery usually takes less than 30 minutes, is performed under a regional anesthesia, and can be performed through two 3 mm incisions.

You must be logged in to post a reply. Please login or click here to create an account.