Exams and Tests to Diagnose Wrist Pain Causes

2010-08-23

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Wrist pain can arise due to various causes, such as stress and repetitive motion caused by daily engagements that heavily rely on repeated wrist activity. These may vary from simple activities such as playing the piano to more physically-exhausting ones. At times, the presence of injury, fracture, and carpal tunnel syndrome may be established as wrist pain causes. Other conditions that cause wrist pain are arthritis, gout, and tendinitis.

Considering the fact that several factors compete as possible causes of the pain, wrist pain diagnosis must be precise so as to fully address the cause, and to efficiently employ the appropriate remedies and treatment methods.

Determining the cause: Exams and diagnosis

Before arriving at a proper diagnosis, doctors usually start with documenting and evaluating the medical history of the patient, his lifestyle, activities, and other pertinent information that may contribute to the cause. Doctors may also proceed to performing neurologic and cardiovascular examination—which includes examination of the neck, spinal column, other related joints, and palpation of the hand and wrist before proceeding to the particular wrist examination. This is to determine whether or not the pain is a result of a more “proximal” complication.

Depending on the initial assessment, doctors may suggest using several tests in order to precisely determine the exact cause. The most commonly used tools and tests for diagnosis include the following:

1. Arthrography

By allowing physicians to examine the joint’s structure and function, arthrography enables them to have a detailed view of the joint’s complications. The main benefits of this wrist diagnosis method lie in detecting tears or lesions of internal structures and ligaments. Conventional arthrography involves an x-ray examination, with the use of fluoroscopy and a particular contrast material that contains iodine. Arthrography may also use magnetic resonance imaging or MRI.

The x-ray imaging, particularly through fluoroscopy, enables doctors to see the movement of internal organs. Through injecting iodine into the joint space, it serves as a coating to the joint structures’ inner lining and appears white on the arthrogram. This enables radiologists to examine the joint. MR arthrography, on the other hand, employs radio frequency pulses and a computer in order to produce images of internal body elements and structures; and it does not involve x-rays.

2. Arthroscopy

Wrist arthroscopy comes as an option when the imaging test results, such as those of MRI and x-ray, fall short in determining the exact cause or complication. The wrist pain diagnosis method allows the physician to see the cartilage surfaces of bones, so as to have a better examination of the ligaments. As such, it is often perceived as one of the most credible ways of gauging the condition of cartilage, ligaments, and bones.

An incision is made in the skin, to serve as the opening for a pencil-sized tool that will be inserted into the wrist. The tool has camera and light inside is, and the gathered internal images are projected onto a monitor.

3. Nerve Tests

For possible cases of carpal tunnel syndrome, the physician may require the patient to undergo an electromyogram (EMG) test. Through inserting a thin electrode into the muscle, the procedure is able to record electrical activity inside the muscle in two instances—when it is sedentary and contracting. Furthermore, EMG may also include nerve conduction tests in order to assess if electrical activity inside the carpal tunnel region is normal, or reduced.