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Pain in the right wrist
  1. S Shyamsundar,
  2. A L Pimpalnerkar
  1. Department of Orthopaedics, Royal Bournemouth Hospital, Bournemouth, UK
  1. Lt Cmdr A L Pimpalnerkar, Department of Orthopaedics, Royal Hospital Haslar, Gosport, Hants PO12 2AA, UK

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Answers on p 445.

A 29 year old female typist presented with a two year history of pain in her right wrist. There was no history of trauma nor was there a history of any other musculoskeletal disorder. Earlier radiographs (fig 1) and clinical examination had proved inconclusive. Subsequent radiographs were taken eight and 12 months later (figs 2 and3).    

Figure 1

Radiograph of the wrist taken previously.

Figure 2

Radiograph of the wrist taken eight months later.

Figure 3

Radiograph of the wrist taken 12 months later.

Questions

(1)
Describe the radiographic features in figs 1, 2, and 3.
(2)
What is the clinical diagnosis? What investigation would have helped clinch the diagnosis at the first presentation.
(3)
What would be your line of management for this patient? Rationalise your answer.

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