Clinical manual assessment of the wrist.
Although hand therapists often evaluate patients with wrist pain, novice and experienced clinicians alike would benefit from a systematic assessment to efficiently identify the source of dysfunction and initiate an appropriate treatment plan. This article proposes a systematic approach for clinical evaluation of the wrist by describing the basic clinical examination (BCE) process and interpreting the findings in terms of common pathology. The BCE will enable the hand therapist to identify conditions that are contraindicated for conservative care and require further physician intervention, determine a working diagnosis for most musculoskeletal problems, and determine the appropriate extra tests to confirm the working diagnosis and/or rule out differential diagnoses. By combining findings from the patient's history, BCE, and special testing, hand therapists can efficiently determine the underlying pathology and provide appropriate treatment that can optimize clinical outcomes.
Hand to Shoulder Center of Wisconsin, Appleton, WI, USA. Electronic address: aporretto@newhands.net.
Ann
A
Porretto-Loehrke
Hand to Shoulder Center of Wisconsin, Appleton, WI, USA.
Cassandra
C
Schuh
Health and Rehabilitation Sciences, Western University, The Roth McFarlane Hand and Upper Limb Centre, London, Ontario, Canada.
Mike
M
Szekeres
D018771:Arthralgia / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000379:methods*; D059408:Pain Management / Q000379:methods; D010808:Physical Examination / Q000379:methods*; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology*
Cyriax-based approach; Differential diagnosis; Manual therapy; Systematic approach; Wrist pain