An approach to the diagnosis of chronic wrist pain.
A clinical algorithm was developed to help establish a diagnosis in patients with chronic wrist pain. The accuracy of the algorithm was examined in a prospective blind study of 40 patients presenting to the Hand Unit with undiagnosed wrist pain and compared with the later findings at arthroscopy, which were believed to be as accurate as currently possible. Using simple examination techniques and conventional radiographs, an accurate diagnosis was made in 80% of cases. Examination techniques including the scapho-lunate shear test and the presence of local tenderness or pseudostability were found to be particularly accurate.
Stanley
J K
JK
Wrightington Hospital NHS Trust, England.
Hodgson
S P
SP
Royle
S G
SG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001182:Arthroscopy; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000473:pathology; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology; D002908:Chronic Disease; D003663:Decision Trees; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D004204:Joint Dislocations / Q000175:diagnosis / Q000000981:diagnostic imaging; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000473:pathology; D016059:Range of Motion, Articular; D016037:Single-Blind Method; D014457:Ulna / Q000000981:diagnostic imaging / Q000473:pathology; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology*