From the Guidelines
The wrist X-ray findings are normal, with no evidence of fractures, bone lesions, subluxations, or soft tissue swelling, indicating a healthy wrist without need for specific medical intervention based on these radiographic results. The bones show no fractures or lesions, meaning there are no breaks or concerning bone growths. The joints appear normal with a 2 mm ulnar negative variance, which is a common anatomical variation where the ulna (forearm bone) is slightly shorter relative to the radius at the wrist joint, as noted in the standard radiographic evaluation of the hand and wrist 1. This variation is often a normal finding and typically doesn't cause symptoms. No subluxations (partial dislocations) are present, indicating stable joint alignment. The soft tissues surrounding the bones and joints show no swelling, suggesting absence of inflammation or injury.
These findings are consistent with the recommendations for the imaging evaluation of chronic hand or wrist pain, which should begin with radiographs to establish a diagnosis or confirm a clinically expected diagnosis 1. The standard radiographic evaluation, including posteroanterior, lateral, and oblique views, allows for the assessment of alignment, including ulnar variance, joint spaces, and soft tissue swelling, as outlined in the guidelines for chronic hand and wrist pain evaluation 1. Given the normal findings and the absence of any significant abnormalities, no further imaging or specific treatment is required based on these radiographic findings, as they represent normal anatomy or minor variations that do not necessitate medical intervention.
From the Research
Findings Explanation
- The given findings indicate that there are no fractures or bone lesions in the bones.
- The joints show a 2 mm ulnar negative variance, which means that the ulna is shorter than usual, and there are no subluxations.
- The soft tissues do not show any swelling.
Ulnar Impaction Syndrome
- Ulnar impaction syndrome is a common source of ulnar-sided wrist pain, usually associated with positive ulnar variance 2, 3, 4, 5, 6.
- However, the given findings show a 2 mm ulnar negative variance, which is not typically associated with ulnar impaction syndrome.
- The diagnosis of ulnar impaction syndrome is made by clinical examination and is supported by radiographic studies 2.
- Treatment options for ulnar impaction syndrome include ulnar-shortening osteotomy, partial resection of the distal dome of the ulna (wafer procedure), and arthroscopic debridement or repair 2, 3, 4, 5, 6.
Treatment Options
- Ulnar shortening osteotomy is a surgical option that can effectively treat pain from ulnar impaction syndrome by unloading the ulnar aspect of the carpus 3.
- The wafer procedure, which involves partial resection of the distal dome of the ulna, is another surgical option for treating ulnar impaction syndrome 2, 5, 6.
- Arthroscopic debridement or repair is also a treatment option for ulnar impaction syndrome, especially for patients with TFCC injuries or associated lunate, triquetrum, and ligamentous damage 4, 5.