Dorsal wrist impingement is pincing of dorsal wrist capsule between the extensor carpi radialis brevis and the dorsal ridge of the scaphoid. It’s diagnosis is strictly clinical.
J Hand Surg [Am]. 2008 Sep;33(7):1201-4. Arthroscopic management of dorsal wrist impingement. Henry M. abstract
- Often minor initialing event
- loaded extesnion hurts – pushing up from chair or pushing heavy door open.
- sometimes associated dorsal wrist ganglion
- secondary issues could be scapholunate instability or scaphoid rotatory subluxation – scaphoid shifts at times and pinches
- Schaphoid shift test(aka Watson test(from http://www.fpnotebook.com/Ortho/Exam/ScphdShftTst.htm
Thumb on tubercle, index dorsally . Push back and forth and as wrist moved radial- ulnar deviation.
If hurts on tubercle is a problem, if clunks – is unstable
Rx – inject steroid which can be repeated 1-2 times
Sometimes capsulectomy done.