Template:Wrist Pain DDX

From WikiMSK

Differential Diagnoses

Acute Wrist Pain

  • Distal radius fracture (often intra-articular in the athlete)
  • Scaphoid fracture
  • Wrist ligament sprain/tear (intercarpal, scapholunate, lunotriquetral)
  • Fracture of hook of hamate
  • Triangular fibrocartilage complex tear
  • Distal radioulnar joint instability
  • Scapholunate dissociation
  • Carpal dislocation
  • Anterior dislocation of lunate
  • Perilunar dislocation
  • Traumatic ulnar artery aneurysm or thrombosis (karate)
  • Dorsal wrist pain - Scaphoid fracture, Scaphoid impaction syndrome, Fracture dislocation of carpus, Lunate fracture, Distal radius fracture, Scapholunate ligament tear, Kienbock's disease (acute onset), Lunotriquetralligament tear, Distal radioulnar joint injury, Carpometacarpal dislocation
  • Volar wrist pain - Carpal instability, Hook of hamate fracture

Subacute Dorsal Wrist Pain

  • Ganglion
  • Intersection syndrome
  • Kienbock's disease
  • Dorsal pole of lunate and distal radius impingement (gymnasts)
  • Posterior interosseous nerve entrapment
  • Inflammatory arthropathy
  • Degenerative joint disease
  • Extensor carpi ulnaris tendinopathy
  • Extensor carpi ulnaris subluxation
  • Injuries to distal radial epiphysis (children)
  • Extensor pollicis longus impingement on Lister's tubercle (occasional rupture)

Subacute Volar Wrist Pain

  • Scaphoid aseptic necrosis
  • Stenosing tendinopathies
  • Flexor carpi ulnaris tendinopathy
  • Carpal tunnel syndrome
  • Ulnar tunnel syndrome
  • Pisotriquetral degenerative joint disease
  • Avascular necrosis of the capitate (weightlifters)
  • Extensor pollicis longus impingement/rupture (gymnasts)

Subacute Ulnar Wrist Pain

  • Triangular fibrocartilage complex tears
  • Ulnar Impaction syndrome
  • Distal radioulnar joint instability
  • Carpal instability
  • Scapholunate dissociation
  • Ulnar nerve compression (cyclists, golfers)
  • Flexor carpi ulnaris tendinopathy
  • Extensor carpi uinaris tendinopathy
  • Extensor carpi ulnaris subluxation
  • Distal radioulnar joint impaction syndromes (golfers)
  • Scaphoid impaction syndrome

Subacute Radial Wrist Pain

Carpal Tunnel Syndrome

  • Cervical radiculopathy Cauda equina syndrome
  • Thoracic outlet syndrome Spinal infection
  • Pronator teres syndrome Malignancy
  • Radial neuropathy Spinal fracture
  • Ulnar neuropathy Metastatic spinal cord compression
  • Tenosynovitis Deep vein thrombosis
  • Raynaud syndrome Axial spondyloarthropathy
  • Inflammatory arthropathy Spinal stenosis
  • Peripheral nerve tumour Synovial cyst
  • Multiple sclerosis Meralgia paraesthetica
  • Amyotrophic lateral sclerosis Hip osteoarthritis
  • Polyneuropathy (eg, diabetic or chronic
  • inflammatory demyelinating polyneuropathy)
  • Polyneuropathy (eg, diabetic or chronic
  • inflammatory demyelinating polyneuropathy)
  • Acute compression syndromes (eg, Saturday
  • night palsy)
  • Compartment syndrome
  • Multiple sclerosis