Condition | Location | Clinical features | Radiographic findings | Associated activities |
Distal radius physis stress syndrome | Radial | Pain with dorsiflexion and axial loading | Widening and irregularity of the physis; palmar spurring of metaphysis | Gymnastics; rock climbing; weight lifting; |
Median neuropathy (Carpal tunnel syndrome) | Radial | Dysesthesia or paresthesias; positive Tinels or Phelan sign | Carpal tunnel view to exclude osseous compression | Racquet, stick, and club sports; cycling; rowing; skiing; keyboard typing |
Radial neuropathy (Wartenburg syndrome) | Radial | Pain and paresthesias over the dorsal thumb and dorsal radial hand | Radiographs not necessary | Activities that involve repeated supination and pronation |
Scaphoid impaction | Radial | Pain over the scapholunate ligament when wrist is dorsiflexed and axially loaded | Normal or may demonstrate ossicle formation | Gymnastics; weight lifting |
de Quervain tenosynovitis | Radial | Pain during pinch grasping or thumb and wrist movement | Radiographs not necessary | Racquet, stick, and club sports; fly fishing; repetitive thumb extension |
Dorsal ganglion | Radial, dorsal | Cystic swelling | Radiographs not necessary | |
Kienbock disease(Osteonecrosis of the lunate) | Radial, dorsal | Mild swelling, persistent pain, crepitation, stiffness and decreased range of motion | AP radiographs demonstrate progressive changes | Martial arts; volleyball |
Ulnar neuropathy (Guyon canal syndrome) | Ulnar | Weakness and paresthesias affecting the 4th and 5th digits | Radiographs not necessary | Racquet, stick, and club sports, cycling |
Ulnar impaction syndrome | Ulnar | Tenderness of ulnar snuff box; tenderness with ulnar deviation | Positive ulnar variance, cyst formation or sclerosis of ulnar head or lunotriquetral interface | Gymnastics (vaulting) |
Triangular fibrocartilage complex (TFCC) tears | Ulnar, dorsal | Point tenderness over the lateral wrist just distal to the ulnar styloid; pain with forced ulnar deviation or TFCC compression test | Associated (but not diagnostic) findings: widening of DRUJ space, positive ulnar variance, fracture of ulnar styloid on AP; dislocation/subluxation on lateral | Impact sports; racquet, stick, and club sports; gymnastics |
Distal radioulnar joint (DRUJ) injury | Ulnar, dorsal | Pain with supination and pronation; positive DRUJ compression or piano key tests | Dislocation can be seen on plain radiographs; MRI may be necessary for instability | Impact sports; racquet, stick, and club sports; gymnastics |
Extensor carpi ulnaris (ECU) tendonitis | Ulnar, dorsal | Tenderness over ECU tendon in ulnar groove exacerbated by wrist extension against resistance | Radiographs not necessary | Rowing; racquet, stick, and club sports |
ECU subluxation | Ulnar, dorsal | Pain and snapping with rotation of forearm; can be observed with ulnar deviation in full supination | Radiographs not necessary | Racquet, stick, and club sports |
Hamate hook fracture | Ulnar, palmar | Pain with sports but not daily activities; point tenderness over the hook of the hamate | Fracture best seen on 45° supination oblique or carpal tunnel view or with computed tomography | Racquet, stick, and club sports |
Flexor tendonitis (flexor carpi radialis [FCR], fexor carpi ulnaris [FCU]) | Palmar | Tenderness over FCR or FCU | Radiographs not necessary | Racquet, stick, and club sports |
Hypothenar hammer syndrome | Palmar | Pain in palm, coldness of digits, abnormal modified Allen test | Radiographs not necessary | Impact sports; martial arts; volleyball; racquet, stick, and club sports |
Intersection syndrome | Dorsal | Tenderness 4 to 6 cm proximal to wrist joint; crepitus with active extension of the wrist | Radiographs not necessary | Rowing; weight training; racquet, stick, and club sports |
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