Wrist Pain Flashcards
What are common causes of acute wrist pain?
Fractures (distal radius, scaphoid), ligamentous injuries, sprains, dislocations, tendonitis.
What key elements should be assessed in the history of a patient with acute wrist pain?
Mechanism of injury, onset of pain, dominant hand, prior injuries, occupational/recreational activities.
What physical exam components are essential for evaluating wrist pain?
Inspection, palpation, range of motion, neurovascular assessment, special tests.
What are red flag symptoms in a patient with wrist pain?
Severe pain, deformity, open wounds, neurovascular deficits.
What are the first imaging modalities for wrist pain evaluation?
X-ray (AP, lateral, oblique views).
When should a CT or MRI be considered for wrist pain?
If X-rays are inconclusive or for suspected scaphoid fractures, ligamentous injuries, or occult fractures.
What fracture is most commonly associated with a fall on an outstretched hand (FOOSH)?
Distal radius fracture (e.g., Colles’ fracture).
What is the most commonly fractured carpal bone?
Scaphoid bone.
What is the risk associated with scaphoid fractures?
Avascular necrosis due to retrograde blood supply.
What physical exam test is used to assess for scaphoid fractures?
Snuffbox tenderness test.
What special test is used to assess for lunate dislocation?
Murphy’s sign (knuckle of the third metacarpal is in line with the others).
What special test is used to evaluate for triangular fibrocartilage complex (TFCC) injury?
TFCC compression test (pain with ulnar deviation and axial compression).
When should a wrist sprain be suspected?
Pain and swelling without fracture on imaging, history of overstretching or twisting.
What is the treatment for a simple wrist sprain?
RICE (Rest, Ice, Compression, Elevation), NSAIDs, splinting if necessary.
What are common symptoms of carpal tunnel syndrome?
Numbness, tingling, or pain in the first three digits, worsened at night.
What tests assess for carpal tunnel syndrome?
Tinel’s sign (tapping over median nerve), Phalen’s test (wrist flexion for 60 seconds).
What is the management for a nondisplaced scaphoid fracture?
Thumb spica splint and repeat imaging in 10–14 days.
When is surgery indicated for wrist fractures?
Significant displacement, intra-articular involvement, or neurovascular compromise.
What is the first step in managing a suspected wrist dislocation?
Immediate neurovascular assessment followed by reduction and splinting.
