The wrist is a complexly built joint. It is built on one side by the ulna and radius, while the other side consists of 8 carpal bones. Strictly speaking, the complete wrist consists of three joints independent of each other (1. the radio carpal, or wrist joint itself, 2. medio carpal and 3. distal radialulnar joint) which all contribute to the hand’s mobility. The ulna and radius are connected via the radialulnar joint, where one finds the important so-called articular disk. This disk is made of soft cartilage which, among other things, has the job of acting like a shock absorber and guaranteeing stability between the ulna and radius. Various forms of stress can lead to traumatic or degenerative damage to the disk, which in turn can cause symptoms in the wrist. In this case, pain is present on the outer edge of the wrist joint especially when rotating the hands or using them as supports.
Other conceivable reasons for wrist-joint pain could be acute or falsely healed fractures, osteoarthritis, carpal ligament injury or ganglion cysts. Sometimes congenital hypermobility through abnormally loose ligaments or tendon sheath inflammation through chronic repeated overstressing of joints can cause wrist complaints.
An accurate examination of the hand is crucial. X-rays, additional functional testing, computer tomography (CT scan) or magnetic resonance imaging (MRI) are often required.
Wrist arthroscopy is a promising method of reaching a conclusive diagnosis if the above mentioned methods have not been successful. As well as this, arthroscopy can actually be used in treatment methods. The arthroscopic examination is performed under either regional or general anaesthetic. Small incisions are made and through these, minimally invasive access is gained to the joint allowing the surgeon to feed through a miniature camera, examining hooks and other instruments. In the case of proliferation of the synovial membrane, which is as a rule, caused by inflammation (synovitis), surplus tissue can be removed.
The removal of ganglion cysts can also be performed using arthroscopy. Ligament injuries can also be localised, tested for function and stability and treated. Disc tears can be diagnosed and smoothed or refixed if required. The extent of osteoarthritis can be directly seen and joint surfaces smoothed.