Clinical examination of the wrist

Abstract

A well-rehearsed and slick clinical examination of the wrist is key to a successful outcome in the FRCS exam as well as ascertaining accurate diagnosis of a patient's symptoms. Precise localization of the pathology from a focused history and thorough examination is crucial prior to requesting appropriate investigations. Although localization of offending pathology can be difficult due to multiple anatomical structures in close proximity, a systematic examination will avoid missed pathology. It is useful to compartmentalize wrist symptoms as being radial sided, central or ulnar sided whilst taking the history as this will direct the examiner to focus their examination accordingly. This article will detail a routine of wrist examination with subsequent focus on specific tests and findings present in common subacute and elective conditions. As with any musculoskeletal examination, the key to accurate diagnosis is working knowledge of underlying anatomy and its relevance to functions of the wrist and hand. Whilst the scope of this article limits discussion of anatomy, it is highly recommended to be well versed with this.