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Wrist sprain, Getting the diagnosis right

January 10, 2016 by Greg Balourdas

The wrist is a very complex joint… with motion nearly equal to the ball and socket joints of the shoulder and hip, it is made up of 10 separate bones held together by a complex lattice of ligaments.  Considering the demand we put on wrists, and the trauma they are subjected to, our wrists hold up pretty well.

Wrist injuries are very common with most the result of falls and include distal radius fractures and scaphoid fractures.  If a ligament tears before a bone breaks, you suffer a wrist sprain.  A sprain is an injury of the structures connecting bone to bone (ligaments).  These injuries vary in severity, and in the case of the wrist, vary in pattern and consequence, by which of the many ligaments of the wrist are involved.

Ligaments do not show up on X-ray, only the bones are seen directly.  An injury to the ligaments of wrist, can however, be inferred by a change in the relationships between the wrist bones.  A motion study with a fluoroscopy unit (motion X-ray), can help make the diagnosis.  Typically this type of study is done in a hospital radiology department but as a specialist limiting my practice to the hand and arm, I have a hand-specific fluoroscopy unit.  The Orthoscan Mobile DI unit is an invaluable adjunct to such wrist and hand examinations.  Cool, don’t you think!

Once a definitive diagnosis is made, treatment can range from rest and immobilization to therapy, injection and surgery.

Early and accurate diagnosis is very important for such injuries, if examination, X-ray and fluoroscopy doesn’t result in an answer, MRI is the definitive way to visualize the ligaments and other soft tissues (non-bone) of the wrist.

If you do fall and symptoms are severe or last for more than a week or two, get in to a specialist, you won’t be sorry.

Take care,
Greg Balourdas, MD

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