?# Scaphoid

[umamadhu]

Hi there,

I feel it must be Dequiverain's disesae or the tenosynovitis.U got to better X-ray to rule out the #.If its the inflammation.JUS give adequate rest to the wrist,use a wrist binder.try cryotherapy.

[karen.hankey]

To test for DeQuervains syndrome place your thumb of the the affected hand into the the palm and wrap your fingers in a fist around it. Then ulnar deviate your wrist. This is called Finklesteins test and will cause pain if DeQuervains is present.

Possible signs for a fractured scaphoid would involve a fall onto an outstretched hand. You would find tenderness in the anatomical snuffbox (the dip around the base of the thumb).

If you are unsure always be cautious and seek an x-ray. Better to be safe then sorry.

[Baby_Physio_Kieran]

Hi, thanks for all the advice - Finklesteins was negative, and the snuff box is a bit tender, but not any more than other side...

I went to a drop-in clinic the other day to get a second (non-paranoid) opinion from a nurse. She was really nice, and didn't become defensive at all when she found out I was a graduate physio. (often happens) She seemed to think it was very unlikely to be a # because of the low intensity pain, although she was leaning more towards a repetitive strain injury, which I disagree with, as I cannot elicit the pain on resisted movements in any range. She also thought that I was unlikely to get a xray referral with the presentation.

I am, myself leaning towards a minor ligament sprain. (?Palmer radiocarpal ligament) The only reason I discounted this at the beginning was the unusual movement-pain pattern considering the site of the pain (i.e. lengthening at the site of pain, by extending and ulnar deviating wrist, was painless) But after looking more indepth at the anatomy of the wrist it would appear that radial deviation actually causes more of a separation between the distal radius and the scaphoid than any other movement. The pain is also at the end of range - which would suggest ligament also.

I have resorted to localised rest (although this is harder than it sounds on a dominant wrist) with movement in pain-free ranges and heat therapy (as it is now sub-acute/chronic stage).

Would appreciate any views on my thoughts/logic or any further treatment advice.

Will keep you updated.