Wrist Osteoarthritis

Other Names

• Wrist Arthritis
• Distal Radioulnar Joint Arthritis
• Radiocarpal Arthropathy

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Background

• May refer to:
  • Scapholunate Advanced Collapse (SLAC)
  • Scaphotrapezio-Trapezoid Arthritis (STT Arthritis)
  • Scaphoid Nonunion Advanced Collapse (SNAC)
  • Distal Radioulnar Joint (DRUJ) Arthritis
  • Pisotriquetrial Arthritis

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Pathophysiology

• See: Osteoarthritis (Main)

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Risk Factors

• Trauma
• Rheumatoid Arthritis

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Differential Diagnosis

• Fractures
  • Distal Radius Fracture
    • Bartons Fracture
    • Chauffers Fracture
    • Colles Fracture
    • Die-Punch Fracture
    • Radial Styloid Fracture
    • Smiths Fracture
  • Distal Ulna Fracture
  • Carpal Fractures
    • Scaphoid Fracture
    • Lunate Fracture
    • Triquetrum Fracture
    • Pisiform Fracture
    • Trapezium Fracture
    • Trapezoid Fracture
    • Capitate Fracture
    • Hamate Fracture
  • Essex Lopresti Fracture
• Dislocations
  • Wrist Dislocation (Radiocarpal and/or Ulnocarpal)
  • Carpometacarpal Joint Dislocation
  • Distal Radioulnar Joint Dislocation
  • Lunate Dislocation
  • Perilunate Dislocation
• Instability & Degenerative
  • Scapholunate Instability
  • Lunotriquetral Instability
  • Scaphoid Nonunion Advanced Collapse
  • Distal Radial Ulnar Joint Instability
  • Kienbocks Disease
  • Dorsal Wrist Impingement
  • Carpal Instability
• Tendinopathies & Ligaments
  • De Quervain's Tenosynovitis
  • Intersection Syndrome
  • TFCC Injury
  • Wrist Tendinopathies
  • Extensor Carpi Ulnaris Tendinopathy
• Neuropathies
  • Carpal Tunnel Syndrome
  • Pronator Teres Syndrome
  • Anterior Interosseus Nerve Syndrome
  • Posterior Interosseus Nerve Syndrome
  • Guyon Canal Syndrome
  • Wartenbergs Syndrome
• Pediatric Considerations
  • Distal Radial Epiphysitis (Gymnast's Wrist)
  • Torus Fracture
• Arthropathies
  • Wrist Osteoarthritis
  • Scaphotrapeziotrapezoidal Joint Arthritis (STT Arthritis)
  • Rheumatoid Arthritis
  • Gout
• Cartilage
  • Osteochondral Defect
• Vascular
  • Hypothenar Hammer Syndrome
• Other
  • Ganglion Cyst of Wrist
  • Ulnar Impingement Syndrome
  • Infectious Tenosynovitis

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Clinical Features

• General: Physical Exam Wrist

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Evaluation

Wrist XR demonstrating moderate radiocarpal arthritis

Radiographs

• Standard Radiographs Wrist
• Standard evaluation for wrist pain
• May require additional views to visualize specific joints

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Classification

• N/A

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Management

Cock Up Wrist Splint

Nonoperative

• Often first line treatment for mild symptoms
  • NSAIDS
  • Brace
  • Wrist Injection with corticosteroids among other injectates
• Cock Up Wrist Splint

Operative

• Address etiology:
  • SLAC
  • Scaphotrapezio-Trapezoid Arthritis
    • Needs to be updated
  • SNAC
  • Pisotriquetrial Arthritis
    • Excise pisiform
  • Distal Radioulnar Joint Arthritis
    • Distal ulna resection or head replacement

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Return to Play

• Highly variable
• Depends on management strategy

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Complications

• Chronic Pain
• Loss of ADLs
• Inability to return to job

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See Also

• Internal
  • Forearm Pain (Main)
  • Wrist Pain (Main)
  • Finger Pain (Main)
  • Hand and Wrist Anatomy (Main)
  • Physical Exam Wrist

External

• Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/

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