Recent Articles of Interest

A repetitive strain injury (RSI) is cluster of conditions resulting from continuous use of tools such as computer keyboard, musical instrument and activities that demand repeated movements.Although the cause of 'inflammation' associated with cumulative trauma have not been clearly elucidated, many factors including mechanical fatigue involving ligaments, tendons and soft tissues have been implicated.

Differential diagnosis depends upon the site of the inflammation and it includes the diagnosis of Achilles tendon injuries, tendonitis, Ankle degeneration, Acromioclavicular degeneration, Carpal Tunnel Syndrome, Anterior cruciate laxity, Gamekeeper's thumb, Elbow degeneration, Neck pain, Knee degeneration, Shin Splints, Suprascapular nerve compression, and tendinopathy. Carpal Tunnel is a very well known problem. Triangular Fibrocartilage Complex Injury, or TFCC, is injury of a little, cartilage-like area in the joint of the wrist. Symptoms include pain on the wrist's ulnar side, a clicking sound, and reduced grip power. Osteonecrosis of the lunate bone in the wrist in those with systemic sclerosis will also result in wrist pain. Osteonecrosis represents a significant reason for wrist pain, more so in scleroderma patients. A positive test for scaphoid compression confirms the presence of the fractured scaphoid in those with no visible fracture in the first x-ray studies.

A definitive test for scaphoid instability is the scaphoid shift test, which uses pressure against the scaphoid tubercle. The compression of the median never at the wrist is the cause of Carpal Tunnel Syndrome (CTS), or median neuropathy, this can lead to pain in the hand. Some cases of carpal tunnel syndrome are caused by repetitive activities, while occur without any known cause. There remains a correlation between a painful dorsal wrist ganglion and wrist joint abnormality, but the exact cause of the dorsal wrist ganglia is still a medical mystery. Scaphoid fractures and dynamic scapholunate instability are both injuries that can happen to the scapholunate ligament. The scapholunate ligament stabilizes the palmar rotation force of the scaphoid against the dorsal rotation force of the lunate and maintains the proximal pole of the scaphoid adjacent to the lunate.

To diagnose a syndrome such as De Quervain's tensynovitis (where tendons in your thumb become inflamed and swollen, greatly limiting movement of the thumb), an x-ray of the bone will be needed. These x-ray images can help a doctor determine the appropriate diagnosis and subsequent treatment of joint pain in the hand or wrist.

Though the true prevalence and natural history of intercarpal ligament injuries are not known, Scapholunate injuries have been reported to occur in association with distal radial fractures. Distal lunate joint instability due to dysfunction of the distal radio-ulnar joint is commonly encountered in patients with rheumatoid disease or following fracture to the distal radius. Hamate fractures constitute 2% of all carpal fractures related to sports activities involving racquets, bats, and clubs. The hamate bone is a triangular bone composed of both a body and a hook.