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Q. Please comment on the severity of my wife's wrist x-ray.

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 09, 2016 and last reviewed on: May 26, 2020

Hi doctor,

My wife is 42 years old. She is feeling pain in the right wrist while moving the palm laterally outward. The movement gets somewhat obstructed slightly and it is not smooth. This has been started after an occasion when she tried to pull or carry one heavy bag a week ago. X-ray has been done on her right wrist which is enclosed herewith. Please comment on the severity of the wound and its medication. Thank you.

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#

Hello,

Welcome to icliniq.com.

  • I have gone through your clinical history and x-rays (attachment removed to protect patient identity) and there is actually no obvious fracture, which is visible.
  • Also, I need to see clinically the site of maximum pain, so it will be helpful for me to better understand your x-ray.
  • Meanwhile, you do intensive ice packs, wrist brace for immobilization and anti-inflammatory medication as per your body's suitability.
  • To me it looks as a case with a ligamentous sprain, which can happen while attempting to lift a heavy weight.
  • Anyway, kindly send me your clinical picture so that I can reply accordingly.

Revert back with the photos to an orthopaedician and traumatologist online -->https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

Thank you doctor,

I am attaching herewith the photograph of her right hand showing the exact location of maximum pain. When the palm moves towards the arrow direction maximum pain occurs in the zone marked red. However, pain also occurs in the right side of her hand in the zone marked in orange color.

#

Hi,

Welcome back to icliniq.com.

  • I have gone through the clinical picture (attachment removed to protect patient identity) sent by you and as I had mentioned earlier, it appears to be a soft tissue insult, which can happen with the mechanism of injury described by you.
  • Most commonly it is the TFCC (triangular fibrocartilage complex), which is a soft tissue ligamentous support on the inner side of the wrist. It can get sprained which has to be initially managed like any other ligament sprain.
  • So, my advice will be as follows. Consult your specialist doctor, discuss with him or her and take the medicine with consent.
  1. Wrist brace for three to four weeks
  2. Intensive ice packs for local application of three to four times in a day for 10 to 15 minutes every time.
  3. You can ask her to take any good anti-inflammatory medication.
  • I suggest tab Hifenac P (combination of Aceclofenac and Paracetamol) one tablet twice a day after meals for three to five days and then one tab SOS (as and when necessary) for pain. Be sure that there should be no pregnancy or any allergy to medication.
  • Physical therapy can be initiated under supervision of a trained physical therapist, but only with modalities like laser therapy of ultrasonic and no exercises.
  • Also, I say just a few words of caution for which you will have to let me know. There should be no increase in pain, swelling or any skin discoloration or any other local signs and symptoms of inflammation like local warmth, etc., during the course of treatment otherwise a physical examination and a few blood tests would need to be done.
  • I think with the above mentioned treatment protocol, she should feel relieved in the next 2 weeks to 20 days, but ask her to use a brace until the pain disappears. Also, any heavy physical activity needs to be avoided with the affected hand.

The Probable causes:

Injury to ligament during attempted lifting of heavy weight.

Regarding follow up:

Revert back after two weeks to an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


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