12: Wrist Pain

Question 1

Most common age range for carpal tunnel syndrome.

Answer 1

30-60

Question 2

T/F Carpal tunnel is more common in males.

Answer 2

False. Females affected 2-5x more than men.

Question 3

Carpal tunnel is usually a repetitive use injury. It is more commonly associated with what 4 conditions?

Answer 3

1. Hypothyroidism
2. Hormonal changes of pregnancy (will subside after delivery)
3. DM
4. Colle’s Fracture

Question 4

If your patient has pain/swelling and tells you they caught themselves on their outstretched hand as they fell, what would you suspect?

Answer 4

• Colles’ Fracture (elderly patients)
• Scaphoid Fracture

Question 5

T/F Carpal tunnel can cause nocturnal pain.

Answer 5

True

Question 6

What type of radiculopathy can mimic carpal tunnel?

Answer 6

C6

Question 7

T/F X-ray all suspected carpal tunnel cases to r/o other causes.

Answer 7

False. Only x-ray for suspected ganglion or fracture. Otherwise it’s a clinical diagnosis.

Question 8

If there is need for further diagnostics in carpal tunnel (no improvement in 6-8 weeks), what test would you use?

Answer 8

EMG/NCS to determine if surgery is indicated

Question 9

Carpal tunnel management (6).

Answer 9

1. Eliminate repetitive trauma
2. NSAIDs
3. Low dose steroids (20 mg prednisolone for 14 days)
4. Control of underlying disorders
5. Refer to specialist if severe
6. Splints/braces

Question 10

Caused by repetitive gripping and twisting motions of the wrist/thumb.

Answer 10

deQuervain’s Tenosynovitis

Question 11

Where is the pain located in deQuervain’s?

Answer 11

Radial base of thumb

Question 12

Management of deQuervain’s (5).

Answer 12

1. X-ray only if related to trauma or suspicious of bony involvement
2. Ice
3. Spica or gutter splint
4. Ortho referral if no improvement in 2 weeks
5. Work restrictions (possibly)