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Wrist Tendinopathies
From WikiSM
Contents
Other Names
- Wrist Flexor Tendinopathy
- Wrist Extensor Tendinopathy
- Wrist Flexor Tendinitis
- Wrist Extensor Tendinitis
- Tenosynovitis
Background
- This page refers to all the general tendinopathies that can affect the wrist including:
- Extensor tendinopathy:
- Flexor tendinopathy:
- Ulnar-sided tendinopathy: FCU ECU
- Radial sided tendinopathy: FCR, ECRB, ECRL
Extensor-sided Tendinopathies
- Sorted by Extensor Tendon Compartments[1]
- 1st Dorsal Compartment
- See: De Quervain's Tenosynovitis
- Affected muscles: Abductor Pollicis Longus, Extensor Pollicis Brevis
- 2nd Dorsal Compartment
- See: Intersection Syndrome
- Affected muscles: 1st dorsal compartment + Extensor Carpi Radialis Longus, Extensor Carpi Radialis Brevis
- 3rd Dorsal Compartment: Drummers Wrist
- Affected muscles: Extensor Pollicis Longus
- 4th Dorsal Compartment:
- Affected muscles: Extensor Indicis, Extensor Digitorum
- 5th Dorsal Compartment: Vaughn-Jackson Syndrome
- Affected muscles: Extensor Digiti Minimi
- 6th Dorsal Compartment: Snapping ECU
- Affected muscles: Extensor Carpi Ulnaris
Flexor-sided Tendinopathies
- Flexor Carpi Radialis
- Uncommon, poorly described in the literature
- Flexor Carpi Ulnaris
- Does not pass through enclosed sheath, thus incapable of triggering
- Palmaris Longus
- Does not pass through enclosed sheath, thus incapable of triggering
Pathophysiology
Risk Factors
Differential Diagnosis
- Fractures
- Dislocations
- Instability & Degenerative
- Tendinopathies & Ligaments
- Neuropathies
- Pediatric Considerations
- Distal Radial Epiphysitis (Gymnast's Wrist)
- Torus Fracture
- Arthropathies
- Cartilage
- Vascular
- Other
Clinical Features
- General: Physical Exam Wrist
- History
- Typically insidious and atraumatic in onset, although there can be acute presentations
- Physical Exam
- Symptoms should be exacerbated by recruiting the affected muscles which can help narrow down the etiology
- For example, ECU tendinitis should involve pain with extension and ulnar deviation
Evaluation
Radiographs
- Standard Radiographs Wrist
- 3 view radiographs are standard
- In the case of tendinopathies, radiographs are typically normal
Ultrasound
MRI
Classification
- N/A
Management
Nonoperative
- Virtually all tendinopathies will be managed nonoperatively
- Discontinue offending activities
- Splinting
- Physical Therapy
- Including Eccentric Exercises
- Corticosteroid Injection
Operative
- In refractory cases and depending on the pathology
- Procedures include
- Tenotomy
Return to Play
- Widely variable
Complications
- Chronic pain
- Loss of ADLs
See Also
- Internal
- External
- Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/
References
- ↑ Adams, Julie E., and Rohan Habbu. "Tendinopathies of the hand and wrist." JAAOS-Journal of the American Academy of Orthopaedic Surgeons 23.12 (2015): 741-750.
Created by:
John Kiel on 5 October 2019 13:51:58
Authors:
Last edited:
13 October 2022 21:50:31
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