The Athlete's Wrist: Ulnar-Sided Pain
09 October 2012 (online)
Ulnar-sided wrist pain is one of the most common symptoms in athletes of baseball, racket sports, golf, and wrestling where there is frequent use of the hands as well as in soccer and running, where hand use is minimal. Compared with all wrist injuries, ulnar-sided wrist injury is a relatively serious condition for athletes because it plays an important role in performing a strong grip and in the rotation of the forearm.
Ulnar-sided wrist pain in athletes can be related to acute trauma or chronic overuse. Acute trauma can lead to bone fractures and sprains/tears of ligaments. Repetitive mechanical stresses to tendons, ligaments, and the joint structures can lead to tendinitis or osteoarthrosis.
Diagnosis of the ulnar-sided wrist pain is challenging both for hand surgeons and radiologists because of the small and complex anatomy. In the present article, we discuss mechanisms of wrist injury, sports-specific ulnar-sided wrist injuries, and the differential diagnosis of ulnar-sided wrist pain.
- 1 Dawson WJ, Pullos N. Baseball injuries to the hand. Ann Emerg Med 1981; 10 (6) 302-306
- 2 Winge S, Jørgensen U, Lassen Nielsen A. Epidemiology of injuries in Danish championship tennis. Int J Sports Med 1989; 10 (5) 368-371
- 3 Hutchinson MR, Laprade RF, Burnett II QM, Moss R, Terpstra J. Injury surveillance at the USTA Boys' Tennis Championships: a 6-yr study. Med Sci Sports Exerc 1995; 27 (6) 826-830
- 4 McCarroll JR. The frequency of golf injury. Clin Sports Med 1996; 15 (1) 1-7
- 5 Gabel GT. Gymnastic wrist injuries. Clin Sports Med 1998; 17 (3) 611-621
- 6 Caine D, Roy S, Singer KM, Broekhoff J. Stress changes of the distal radial growth plate. A radiographic survey and review of the literature. Am J Sports Med 1992; 20 (3) 290-298
- 7 DiFiori JP, Puffer JC, Mandelbaum BR, Mar S. Factors associated with wrist pain in the young gymnast. Am J Sports Med 1996; 24 (1) 9-14
- 8 Mandelbaum BR, Bartolozzi AR, Davis CA, Teurlings L, Bragonier B. Wrist pain syndrome in the gymnast. Pathogenetic, diagnostic, and therapeutic considerations. Am J Sports Med 1989; 17 (3) 305-317
- 9 Fyrkman G. Fracture of the distal radius including sequelae—shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand Suppl 1967; (Suppl 108) 3
- 10 Nakamura T, Peimer CA, Moy OJ , et al. Relationship between fracture of the ulnar styloid and DRUJ instability: a biomechanical study. J Bone Joint Surg Am . In press
- 11 Andresen R, Radmer S, Sparmann M, Bogusch G, Banzer D. Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study. Invest Radiol 1999; 34 (1) 46-50
- 12 Bora Jr FW, Didizian NH. The treatment of injuries to the carpometacarpal joint of the little finger. J Bone Joint Surg Am 1974; 56 (7) 1459-1463
- 13 McCarty V, Farber H. Isolated fracture of the pisiform bone. J Bone Joint Surg Am 1946; 28: 390
- 14 Tanaka T, Yoshioka H, Ueno T, Shindo M, Ochiai N. Comparison between high-resolution MRI with a microscopy coil and arthroscopy in triangular fibrocartilage complex injury. J Hand Surg Am 2006; 31 (8) 1308-1314
- 15 Yoshioka H, Tanaka T, Ueno T , et al. Study of ulnar variance with high-resolution MRI: correlation with triangular fibrocartilage complex and cartilage of ulnar side of wrist. J Magn Reson Imaging 2007; 26 (3) 714-719
- 16 Watanabe A, Souza F, Vezeridis PS, Blazar P, Yoshioka H. Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol 2010; 39 (9) 837-857
- 17 Cerezal L, del Piñal F, Abascal F, García-Valtuille R, Pereda T, Canga A. Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics 2002; 22 (1) 105-121
- 18 Imaeda T, Nakamura R, Shionoya K, Makino N. Ulnar impaction syndrome: MR imaging findings. Radiology 1996; 201 (2) 495-500
- 19 Werner SL, Plancher KD. Biomechanics of wrist injuries in sports. Clin Sports Med 1998; 17 (3) 407-420