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Tests and diagnosis
By Mayo Clinic staffDuring the physical exam, your doctor may:
- Check your wrist for points of tenderness and swelling
- Ask you to move your wrist to see if your range of motion has been decreased
- Assess your grip strength and forearm strength
In some cases, your doctor may suggest imaging tests, arthroscopy or nerve tests to help pinpoint the cause of your wrist pain.
Imaging tests
- X-rays. Using a small amount of radiation, simple X-rays can reveal bone fractures, as well as evidence of osteoarthritis.
- Computerized tomography (CT) scan. CT scans can provide more-detailed views of the bones in your wrist. A CT scan takes X-rays from several directions and then combines them to make a two-dimensional image.
- Bone scan. In a bone scan, a small amount of radioactive material is injected into your bloodstream. This makes injured parts of your bones brighter on the resulting scan images.
- Magnetic resonance imaging (MRI). MRIs use radio waves and a strong magnetic field to produce detailed images of your bones and soft tissues. For a wrist MRI, you may be able to insert your arm into a smaller device rather than have your entire body slide into a full-size MRI machine.
Arthroscopy
If imaging test results are inconclusive, your doctor may perform an arthroscopy, a procedure in which a pencil-sized instrument is inserted into your wrist via a small incision in your skin. The instrument contains a light and a tiny camera. Images are projected onto a television monitor.
Nerve tests
If your doctor thinks you have carpal tunnel syndrome, he or she might order an electromyogram (EMG). This test measures the tiny electrical discharges produced in your muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when the muscle is at rest and when it's contracted. Nerve conduction tests also are performed as part of an EMG to assess if the electrical impulses are slowed in the region of the carpal tunnel.
- Swigert CR. Hand and wrist pain. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/208746819-6/0/1807/0.html. Accessed Aug. 30, 2011.
- Questions and answers about sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Sprains_Strains/default.asp. Accessed Aug. 30, 2011.
- Anderson BC. Evaluation of the adult patient with wrist pain. http://www.uptodate.com/home/index.html. Accessed Aug. 30, 2011.
- Upton DS, et al. Acute wrist injuries in children and adolescents. http://www.uptodate.com/home/index.html. Accessed Aug. 30, 2011.
- Deune EG, et al. The patient with hand, wrist or elbow pain: Introduction. In: JB, et al. Current Rheumatology Diagnosis & Treatment. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=38. Accessed Aug. 30, 2011.
- Ferri FF. Wrist pain. In: In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed Aug. 30, 2011.
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