Dorsal Wrist Impingement – How to Diagnose

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.

Any expereince with this?

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