Wrist Examination

A. HISTORY :
1. Where is your pain?
• De Quervain’s tenosynovitis complain of
pain over the radial styloid process.
• carpal tunnel syndrome → pain,
numbness,&tingling over the wrist, palm,
&first three digits &median half of the
fourth digit.
• trigger finger may or may not have pain
when their finger“triggers.”
• a fracture will → pain over fracture site.
2. What is the quality of your pain and/or
symptoms (e.g., sharp,electric, dull,
aching, numbness, tingling, etc.)?

• Patients with carpal tunnel syndrome→

pain, numbness, tingling, and electric
sensations in their first three digits.
3. What are your occupation and hobbies?
• Patients who work at a desk, type, or who
perform other repetitive activities that involve
simultaneous wrist and finger flexion are
prone to develop carpal tunnel syndrome.
4. When did your symptoms begin?
• most useful for eliciting a history of trauma that
may have precipitated a fracture.
• “skier’s thumb” will typically describe a fall onto
an outstretched arm with an abducted thumb,
such as with a ski pole in their hand, preventing
thumb adduction.
• The question also offers an indication of
chronicity.More chronic symptoms are less likely
to spontaneously resolve,and this information will
be most helpful when deciding on what imaging
studies and treatments to order.
5. Do you ever have symptoms at night
that awaken you from sleep?
• Night-time symptoms that wake the patient
from sleep are a classic sign of carpal
tunnel syndrome.
6. Have you tried any treatments for your
pain and have they helped?
• This question is more useful when you are
deciding which diagnostic studies, if any, to
order and how to treat your patient.
B. Physical examination :
a. Inspection :
b. Palpation :
c. Movements :
d.1.Crepitus :
D.2.De Quervain’s :
D.3. Carpal Tunnel Synd :
D.4. Ulnar Tunnel Synd :