12: Wrist Pain Flashcards
Most common age range for carpal tunnel syndrome.
30-60
T/F Carpal tunnel is more common in males.
False. Females affected 2-5x more than men.
Carpal tunnel is usually a repetitive use injury. It is more commonly associated with what 4 conditions?
- Hypothyroidism
- Hormonal changes of pregnancy (will subside after delivery)
- DM
- Colle’s Fracture
If your patient has pain/swelling and tells you they caught themselves on their outstretched hand as they fell, what would you suspect?
- Colles’ Fracture (elderly patients)
- Scaphoid Fracture
T/F Carpal tunnel can cause nocturnal pain.
True
What type of radiculopathy can mimic carpal tunnel?
C6
T/F X-ray all suspected carpal tunnel cases to r/o other causes.
False. Only x-ray for suspected ganglion or fracture. Otherwise it’s a clinical diagnosis.
If there is need for further diagnostics in carpal tunnel (no improvement in 6-8 weeks), what test would you use?
EMG/NCS to determine if surgery is indicated
Carpal tunnel management (6).
- Eliminate repetitive trauma
- NSAIDs
- Low dose steroids (20 mg prednisolone for 14 days)
- Control of underlying disorders
- Refer to specialist if severe
- Splints/braces
Caused by repetitive gripping and twisting motions of the wrist/thumb.
deQuervain’s Tenosynovitis
Where is the pain located in deQuervain’s?
Radial base of thumb
Management of deQuervain’s (5).
- X-ray only if related to trauma or suspicious of bony involvement
- Ice
- Spica or gutter splint
- Ortho referral if no improvement in 2 weeks
- Work restrictions (possibly)