Wrist Work-Up

Wrist pain may be due to a number of causes. Many of these problems originate from inside the wrist joint.

The wrist joint contains many small bones all covered by cartilage and connected by an intricate system of ligaments. A disruption of cartilage or any of these ligaments could lead to “wrist instability” and pain. If untreated, this could also lead to arthritis. Treatment depends on exactly which structure is injured, and to what extent.

Regular x-rays do not show cartilage or ligaments. We have therefore come up with a protocol which allows us to diagnose wrist pain, with some accuracy.

Our wrist work-up consists of three procedures:

Fluoroscopy: This consists in observing the wrist bones, their relationship and pattern of motion with low dose x-rays.

Arthrogram: In this study a contrast material (dye) is injected into the wrist joint and the flow of that material is observed with fluoroscopy.
The “dye” coats the ligaments and cartilage and reveals their condition.

Arthroscopy: In this procedure a small camera is used to directly look inside the wrist joint. Some wrist problems can actually be treated at
that time, with the camera, avoiding another operation at a later date.

All three procedures are done at the Surgery Center, as an outpatient, under general anesthesia. Regional anesthesia is available to
those who might enjoy watching these procedures on the TV screen.

Each procedure has an inherent rate of inaccuracy. By combining these three procedures, we feel that we can decrease the margin of error tremendously. The findings are discussed with the patient in detail at the first post-operative visit a few days later. The need for any further treatment is also discussed at that time.