Jnl Wrist Surg 2017; 06(04): 276-279
DOI: 10.1055/s-0037-1599829
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Dorsal Wrist Pain in the Extended Wrist-Loading Position: An MRI Study

Erin M. Nance
Hospital for Special Surgery, New York, New York
,
David J. Byun
Hospital for Special Surgery, New York, New York
,
Yoshimi Endo
Hospital for Special Surgery, New York, New York
Department of Radiology, Weill Cornell Medical College, New York, New York
,
Scott W. Wolfe
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New York
,
Steve K. Lee
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New York
› Author Affiliations
Further Information

Publication History

05 December 2016

31 January 2017

Publication Date:
08 March 2017 (eFirst)

Abstract

Background The etiology of dorsal wrist pain associated with loading of the wrist in extension has not been clearly identified in the literature.

Purpose Many exercise disciplines incorporate upper extremity weight-bearing exercises in an extended wrist posture, for example push-ups, plank position, and various yoga and Pilates poses. This study evaluates patients with dorsal wrist pain in the extended wrist-loading position and identifies anatomic abnormalities in the wrist using magnetic resonance imaging (MRI).

Methods A retrospective chart review was performed comparing MRI of patients who complained of dorsal wrist pain while performing weight bearing in a wrist extension position with a control group of patients who complained of ulnar-sided wrist pain. The primary MRI outcome was dorsal wrist pathology, including occult dorsal ganglion cyst, scapholunate ligament tear or degeneration, and dorsal capsulitis.

Results Dorsal wrist pathology was significantly more prevalent in patients with dorsal wrist pain (84%) than in the patient cohort with ulnar-sided wrist pain (12%). Occult dorsal ganglion cysts were the most common sources of pathology (76%).

Conclusion MRI demonstrated an identifiable dorsal abnormality in 84% of patients with dorsal wrist pain associated with weight bearing on the extended wrist. Occult dorsal ganglion cysts are the most common cause of dorsal wrist pain, followed by partial scapholunate tears. When patients complain of dorsal wrist pain during specific extended loading wrist positions such as push-ups, yoga, or Pilates poses, an MRI may be warranted to help identify anatomic abnormalities that may help guide treatment choices.

Level of Evidence Diagnostic, Level III.