During the physical exam, your doctor may:
- Check your wrist for tenderness, swelling or deformity
- Ask you to move your wrist to see if your range of motion has been decreased
- Assess your grip strength and forearm strength
In some cases, your doctor may suggest imaging tests, arthroscopy or nerve tests.
- X-rays. This is the most commonly used test for wrist pain. Using a small amount of radiation, X-rays can reveal bone fractures, as well as signs of osteoarthritis.
- CT. This scan can provide more-detailed views of the bones in your wrist and may help find fractures that don't show up on X-rays.
- MRI. This test uses radio waves and a strong magnetic field to produce detailed images of your bones and soft tissues. For a wrist MRI, you may be able to insert your arm into a smaller device instead of whole-body MRI machine.
- Ultrasound. This simple, noninvasive test can help visualize tendons, ligaments and cysts.
If imaging test results are inconclusive, your doctor may perform an arthroscopy, a procedure in which a pencil-sized instrument called an arthroscope is inserted into your wrist through a small incision in your skin. The instrument contains a light and a tiny camera. Images are projected onto a television monitor. Arthroscopy is now considered the gold standard for evaluating long-term wrist pain. In some cases, your doctor may repair wrist problems through the arthroscope.
If your doctor thinks you have carpal tunnel syndrome, he or she might order an electromyogram (EMG). This test measures the tiny electrical discharges produced in your muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when the muscle is at rest and when it's contracted. Nerve conduction studies also are performed as part of an EMG to assess if the electrical impulses are slowed in the region of the carpal tunnel.
Nov. 04, 2011
- Swigert CR. Hand and wrist pain. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/208746819-6/0/1807/0.html. Accessed Aug. 30, 2011.
- Questions and answers about sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Sprains_Strains/default.asp. Accessed Aug. 30, 2011.
- Anderson BC. Evaluation of the adult patient with wrist pain. http://www.uptodate.com/home/index.html. Accessed Aug. 30, 2011.
- Upton DS, et al. Acute wrist injuries in children and adolescents. http://www.uptodate.com/home/index.html. Accessed Aug. 30, 2011.
- Deune EG, et al. The patient with hand, wrist or elbow pain: Introduction. In: JB, et al. Current Rheumatology Diagnosis & Treatment. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=38. Accessed Aug. 30, 2011.
- Ferri FF. Wrist pain. In: In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed Aug. 30, 2011.
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