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Background/Objectives: Musculoskeletal symptoms, such as neck pain, back pain, and eye strain, are prevalent in modern work environments, particularly among individuals engaged in prolonged sitting and repetitive tasks. This study aimed to explore the prevalence of these symptoms and the impact of ergonomic tool usage, break frequency, posture awareness, and proactive measures on symptom intensity and daily functioning. Methods: This cross-sectional pilot study used a self-developed questionnaire to assess the prevalence and intensity of musculoskeletal symptoms among participants aged 6–18 years. The survey collected data on ergonomic tool usage, break frequency, posture awareness, and proactive measures (such as taking breaks and seeking professional help). Symptom intensity was assessed across common musculoskeletal issues. Internal consistency was assessed using Cronbach's Alpha. Statistical analyses, including descriptive statistics, Chi-squared tests, ANOVA, and Spearman's correlation, were used to identify significant correlations and associations between variables. Results: A significant proportion of participants reported moderate to severe symptoms, including neck pain, back pain, and eye strain. Participants who used ergonomic tools reported significantly lower symptom intensity (<0.001). A positive correlation was found between fewer breaks and higher symptom intensity (r = 0.908, p < 0.001). Those with higher posture awareness reported lower symptom intensity (p < 0.001). Proactive measures, including regular breaks and ergonomic interventions, were perceived as effective strategies for managing symptoms. Increased symptom intensity was associated with reduced ability to perform daily activities (p < 0.001). Conclusions: The study highlights the significant role of ergonomic tools, posture awareness, and regular breaks in mitigating musculoskeletal symptoms. Proactive measures, including structured interventions, can effectively reduce symptom intensity and improve daily functioning. These findings suggest that workplace health strategies focusing on ergonomics and posture education are crucial for reducing the impact of musculoskeletal discomfort on employee well-being and productivity. [ABSTRACT FROM AUTHOR]

De Quervain’s disease is characterized by stennosing tenosynovitis in the first extensor wrist compartment. With the growing popularity of video gaming, the incidence of de Quervain’s disease has continued to rise among teenagers and youths. There is a need to determine the correlation between gaming and de Quervain’s disease. To assess the association between playing video games and thumb and wrist pain among medical students at King Abdulaziz University. This cross-sectional survey study was conducted among medical students at King Abdulaziz University between July 2020 and October 2020. Statistical analyses were performed using SPSS version 23. Most medical students (82%) played video games; among them, 36% and 59% reported using PlayStations and mobile phones, respectively. The mean ± SD pain severity was 1.63 ± 2.65, with 1.4% and 62.9% reported experiencing the most severe pain and no pain, respectively. Further, 12.9%, 15.1%, and 10.1% of the participants reported stretching their fingers before playing, having problems carrying things, and the pain affecting their daily activities, respectively. Most of our participants played video games mainly using mobile phones and PlayStations. However, a majority of them did not experience any pain; moreover, we observed an association of pain episodes and severity with the playing duration and devices used. [ABSTRACT FROM AUTHOR]

On‐water rowing is a sport where participants make extensive, powerful, and complex repetitive movements with their wrists to pull and feather (twist) the oar. Herein, the aim is to assess the frequency and perceived causes of wrist and forearm pain in rowers and, in particular, assess whether there are any possible mechanical issues that could be addressed through the use of auxetic technology. Through an online survey of 145 on‐water rowers, it is found that 33.8% of the rowers reported wrist or forearm pain arising from rowing. The majority (67.3%) consider over‐gripping to be the cause while one out of five associated it with periods of tension and anxiety, which also led them to over‐grip. This indicates that rowing handles could benefit from the use of mechanical metamaterials, auxetics in particular, owing to their anomalous manner in how they deform when subjected to mechanical deformations. Moreover, given the rise in popularity of coastal rowing, which will become an Olympic discipline alongside classic rowing as from the 2028 Los Angeles Olympic Games, the potential use of auxetics in the manufacture of protective gear for use in coastal rowing is also discussed. [ABSTRACT FROM AUTHOR]

Introduction: Public-facing resources for non-traumatic wrist disorders (NTWD) exist, but care recipients and healthcare professionals alike are uncertain where to access the most useful resources and have raised concerns over the quality of information provided. Previous studies involving stakeholders highlight a need for quality evaluation of these resources. The aim of this study was to identify website resources accessible to UK-based online health seekers and explore their content through quality assessment. Methods: A scoping review of public-facing websites was conducted in accordance with Joanna Briggs Institute guidelines and PRISMA-ScR checklist. An a-priori search strategy was performed of publicly accessible websites using lay terms were entered into a simple Google search. The DISCERN tool was used to appraise the quality of health information with additional data charted to pre-determined criteria. Results: The 82 websites meeting inclusion criteria scored an average of 2/5 DISCERN. Nine funding categories existed with private service websites were the most common. 18 different diagnoses were found with twenty different management interventions were recommended. Conclusion: Considerable variation was found in the quality of websites providing information which people with NTWD are likely to access. Quality and trustworthiness of website information on NTWD are not the preserve of any sector or organisation and we identified potential for improvements across the board. [ABSTRACT FROM AUTHOR]

Diagnosing the cause of ulnar-sided wrist pain can be difficult in the pediatric and adolescent age group. While frequently used, the diagnostic accuracy of magnetic resonance image (MRI), as compared with intraoperative arthroscopic findings, is not well-described in this population. This study aimed to determine concordance rates between magnetic resonance and arthroscopic findings depending on the specific ulnar wrist pathology. A retrospective review was performed to identify pediatric and adolescent patients who underwent operative treatment of ulnar wrist pain between 2004 and 2021. Patients were included in the analysis if they were <18 years of age, complained of ulnar-sided wrist pain, underwent MRI of the affected wrist with an available report interpreted by a consultant radiologist, and had a diagnostic arthroscopy procedure within one year of imaging. Ulnar pathologies analyzed included triangular fibrocartilage (TFCC) tears, ulnotriquetral (UT) ligament tears, lunotriquetral ligament abnormalities, and ulnocarpal impaction. A total of 40 patients with a mean age of 15-years-old (range 11 to 17) were included in the analysis. Twenty-four were female, and approximately half had their dominant extremity affected. Most had a history of antecedent trauma (n = 34, 85%), but only 15/40 (38%) had a history of fracture. The mean duration of symptoms prior to presentation was six months (standard deviation, 7). The most common etiologies were Palmer 1B TFCC tears (n = 27, 68%) followed by UT split tears (n = 11, 28%). MRI overall demonstrated high specificity (82% to 94%), but low sensitivity (14% to 71%) for ulnar-sided wrist conditions. Accuracy varied between 70% and 83% depending on the specific injury. While MRI is a useful adjunct for determining the cause of ulnar wrist pathologies, findings are often discordant when compared with diagnostic arthroscopy. Surgeons should have a high degree of suspicion for TFCC-related pathology in the setting of positive provocative clinical examination despite negative MRI findings in young patients. Diagnostic IIb. [ABSTRACT FROM AUTHOR]

The extensor carpi ulnaris (ECU) is primarily responsible for extension and ulnar deviation at the wrist. Secondary to repetitive loading of, or acute trauma to the flexed, supinated and ulnarly deviated wrist, the ECU tendon can be a common source of ulnar-sided wrist pain. Common pathology includes ECU tendinopathy, tenosynovitis, tendon instability, and tendon rupture. Extensor carpi ulnaris pathology commonly occurs in athletes and patients with inflammatory arthritis. Given the multitude of available methods to treat ECU tendon pathology, the aim of our study was to outline operative management of ECU tendon pathology, with emphasis on reviewing techniques for addressing ECU instability. We acknowledge a continuing debate between anatomical and nonanatomical techniques for ECU subsheath reconstruction. However, use of a portion of the extensor retinaculum for nonanatomical reconstruction is commonly used and demonstrates successful outcomes. Future comparative studies on ECU fixation are required to increase data on patient outcomes, to further define and standardize these techniques. [ABSTRACT FROM AUTHOR]

BackgroundPurposeMethodsResultsConclusionOccult scaphoid fractures are difficult to diagnose radiographically. Evidence regarding prevalence and diagnostic accuracy of clinical tests is growing; however, gaps in knowledge remain and further research is needed.This study aimed to determine the prevalence of occult scaphoid fractures and other hand/wrist fractures, plus any clinical/demographic findings diagnostic of scaphoid fractures.Prognostic prospective cohort study. Patients referred with diagnosis of occult scaphoid fractures, non-diagnostic radiographs, and one or more positive provocative test for scaphoid fractures were included. Clinical data were compared to reduce sequence magnetic resonance imaging. Univariate logistic regression was used to determine significance. Multivariable logistic regression was used to determine the effect size of these variables.Of 197 included participants, 43(22%) had a scaphoid fracture and 59(30%) had an occult fracture other than scaphoid. Average age of patients with confirmed occult scaphoid fractures was 22 years old. Distal pole fractures were the most common scaphoid fracture (n = 28/65.1%, average age 16.9 years). Three clinical tests (pain with ulnar-deviation, anatomical snuffbox swelling and pain-free grip) plus two demographics (age <23 and male) resulted in accuracy of 81.7%, positive predictive value of 73.3%, and negative predictive value of 82.4% in diagnosing scaphoid fractures.This study confirms a high prevalence of occult fractures in our population. Patients demonstrating the relevant demographics and positive clinical tests may be appropriate to treat as scaphoid fractures without advanced imaging. Most patients will present with differing clinical findings and/or demographics, and routine use of magnetic resonance imaging is recommended. [ABSTRACT FROM AUTHOR]

De Quervain's tenosynovitis, a common condition affecting the first dorsal compartment of the wrist, is characterized by pain, swelling, and restricted tendon mobility, often resulting from repetitive manual tasks or biomechanical strain. This review integrates insights from three recent studies, emphasizing the multifactorial etiology, advanced diagnostic techniques, and evolving treatment modalities. Etiological factors include mechanical strain, anatomical variations, and degenerative changes, with ultrasonography emerging as a critical tool for enhancing diagnostic accuracy and guiding therapeutic strategies. Conservative treatments such as splinting, corticosteroid injections, and occupational therapy remain the cornerstone of management, while surgical decompression offers definitive relief for refractory cases. Emerging rehabilitative approaches, including graded tendon-loading protocols, and innovations in imaging and therapy, highlight a shift toward more precise and patient-centered care. Despite advancements, challenges persist in optimizing treatment protocols and addressing long-term functional recovery. Further research is essential to refine diagnostic and therapeutic strategies, reduce recurrence rates, and improve patient outcomes.

Calcific tendinosis is characterized by the deposition of calcium hydroxyapatite crystals within the substance of the tendon. We present a case of a 52-year-old female who presented with a 6-month history of right wrist pain, along with a palpable and tender lump in the region of the flexor carpi radialis tendon at the level of the distal radius. Radiographs confirmed the presence of calcific tendinosis of the flexor carpi radialis tendon. The patient was referred for hand therapy sessions and was prescribed nonsteroidal anti-inflammatory drugs, which led to a gradual improvement after 4 months. A repeat radiograph confirmed the resolution of the previous calcific focus at the flexor carpi radialis tendon region. This case highlights the importance of considering rare causes of wrist pain such as this case. Various treatment modalities are available, including surgical management, but ultimately, treatment should be within a multidisciplinary team environment. [ABSTRACT FROM AUTHOR]

Abstract Background As acute myocardial infarction (AMI) prevalence is increasing because of lifestyle changes, the incidence of atypical symptoms in acute coronary syndrome (ACS) is rising and making misdiagnosing of this fatal event more probable. To better approach the patients with atypical symptoms, we tend to present a rare case of AMI with wrist pain. Case report A 41-year-old man presented to the emergency room (ER) with severe both-hand wrist pain and mild epigastric pain. His electrocardiogram (ECG) showed anterior ST-elevation myocardial infarction (MI) with an ejection fraction of 35–40%. His angiography showed severe left anterior descending artery (LAD), and first obtuse marginal artery (OM1) artery stenosis. He underwent Primary percutaneous coronary intervention (PCI). The patient recovered without serious complications and was discharged the day after PCI. Discussion In this rare case of AMI with wrist pain, it is important to know that atypical symptoms can be present at various levels of symptoms, which prevents future misdiagnosis.

Background: As acute myocardial infarction (AMI) prevalence is increasing because of lifestyle changes, the incidence of atypical symptoms in acute coronary syndrome (ACS) is rising and making misdiagnosing of this fatal event more probable. To better approach the patients with atypical symptoms, we tend to present a rare case of AMI with wrist pain. Case report: A 41-year-old man presented to the emergency room (ER) with severe both-hand wrist pain and mild epigastric pain. His electrocardiogram (ECG) showed anterior ST-elevation myocardial infarction (MI) with an ejection fraction of 35–40%. His angiography showed severe left anterior descending artery (LAD), and first obtuse marginal artery (OM1) artery stenosis. He underwent Primary percutaneous coronary intervention (PCI). The patient recovered without serious complications and was discharged the day after PCI. Discussion: In this rare case of AMI with wrist pain, it is important to know that atypical symptoms can be present at various levels of symptoms, which prevents future misdiagnosis. [ABSTRACT FROM AUTHOR]

The addition of aromatase inhibitors has improved cancer-related outcomes in postmenopausal patients with estrogen receptor-positive breast cancer. However, aromatase inhibitor can be associated with a constellation of adverse musculoskeletal effects that comprises bone loss, arthralgia, myalgia, and tendinopathy. This medication complication, known as aromatase inhibitor-associated musculoskeletal syndrome, can limit treatment tolerability in many patients because of the high prevalence of aromatase inhibitor-associated musculoskeletal syndrome among those on aromatase inhibitor. The hand and wrist are the most affected joints in aromatase inhibitor-associated musculoskeletal syndrome, with patients presenting with symmetric arthralgia, stiffness, and tendinopathy. Radioulnar joint subluxation with extensor tendon tear has not been previously reported in patients with aromatase inhibitor-associated musculoskeletal syndrome. This is a case report of a 72-yr-old breast cancer survivor on an aromatase inhibitor presenting with chronic dominant wrist pain, weakness, and 5th digit finger drop. An extensor digitorum minimi tendon tear and radioulnar instability were identified using diagnostic musculoskeletal ultrasonography. This case illustrates the utility of in-office ultrasonography combined with dynamic examination for the often underrecognized pathology associated with aromatase inhibitor-associated musculoskeletal syndrome in breast cancer survivors. [ABSTRACT FROM AUTHOR]

Background and Objectives: Non-specific chronic wrist pain is wrist pain that occurs without a specific cause, such as trauma, and may limit the range of motion of the joints of the wrist and hand, affecting muscle strength, grip strength, and function. This study aimed to determine the effects of grip-strengthening exercises combined with wrist stability training on pain and function in patients with non-specific chronic wrist pain. Materials and Methods: The subjects of the study were 31 patients with wrist pain. To determine the effect of grip-strengthening exercises combined with wrist stability training, 15 participants participated in grip-strengthening exercises combined with wrist stability training and 16 control subjects participated. The experimental group participated in wrist-stability training. Grip-strengthening exercises combined with wrist stability training were performed for 20 min/day twice a week for 4 weeks, and relaxation massage and conservative physical therapy were performed for 20 min/day twice a week for 4 weeks. The control group received relaxation massage and conservative physical therapy for 40 min/day twice a week for 4 weeks. A visual pain scale was used to evaluate the degree of pain before and after treatment, and a patient-rated wrist evaluation was used to evaluate wrist function. Results: The results showed that the visual score significantly decreased in the time effect before and after the intervention in both groups (p < 0.001), patient-rated wrist evaluation significantly decreased (p < 0.001), and grip strength and muscle strength significantly increased (p < 0.001). The results of this study showed that grip-strengthening exercises combined with wrist stability training were effective in improving pain, function, grip strength, and muscle strength in patients with non-specific chronic wrist pain. Conclusions: Grip-strengthening exercises combined with wrist stability training can be used as an effective intervention method to improve pain, function, grip strength, and muscle strength, emphasizing the need for wrist exercise interventions in patients with non-specific chronic wrist pain in the future. [ABSTRACT FROM AUTHOR]

Isolated unilateral absence of lunate is an extremely rare condition with only one such case reported in English literature so far. The rarity of this condition can lead to diagnostic dilemma, especially if patient has an old history of trauma or surgery around the wrist, leading to unnecessary intervention and difficulty in ensuring a good surgical outcome. We present such a case and discuss the clinical pointers to the diagnosis of this condition. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Background: Osteochondroma, the most common benign bone tumor, typically occurs in long bones but rarely in the carpus. When found in the carpus it poses diagnostic challenges, warranting differential diagnosis to distinguish it from other conditions like intercarpal joint degeneration, ligament lesions, nerve compression, or traumatic injuries. Case report: We present case of a 55-year-old male patient with 6 months of right wrist pain. The patient had no relevant history of trauma or prodromal symptoms. Hand examinations revealed a tenderness to palpation in the region of the scaphoid tubercle and scapho-trapezoidal joint. Sensory examination was normal. Surgery was performed to repair the torn FCR tendon and excise the lesion simultaneously. Histology revealed benign neoplasm composed of trabeculae of mature bone covered with an outer sheath of hyaline cartilage. Histomorphology was suggestive of osteochondroma. Post-operatively there was immediate pain relief. No recurrence was noted on follow-up visits. Conclusion: This case report contributes to the expanding body of knowledge on the clinical presentation, diagnosis, and management of scaphoid osteochondromas, highlighting the need for a nuanced approach to wrist pain, even in the absence of trauma or prodromal symptoms. Level of evidence: Level IV.

Carpal boss is a bony protrusion on the dorsal aspect of wrist quadrangular joint. The exact cause and prevalence are not well understood. Most of the patients are asymptomatic, although some experience pain, bony prominence, restricted mobility, and joint instability in sever neglected cases. We are presenting a case of a 24-year-old male had chronic dorsal wrist pain with bony prominence appearance underwent surgical excision of a carpal boss lesion in concomitant with soft tissue ganglion cyst over the carpal boss after failed conservative management, resulting in significant symptom improvement and restored range of motion. Carpal boss lesion is a common condition that can be undiagnosed due to asymptomatic presentation or the presence of overlying soft tissue pathology as ganglion cyst. Although conservative treatment is helpful in some patients, most symptomatic carpal boss lesion patients eventually need surgical excision. [ABSTRACT FROM AUTHOR]

Introduction: Non-traumatic wrist disorders (NTWD) are commonly encountered yet sparse resources exist to aid management. This study aimed to produce a literature map regarding diagnosis, management, pathways of care and outcome measures for NTWDs in the United Kingdom. Methods: An interdisciplinary team of clinicians and academic researchers used Joanna Briggs Institute guidelines and the PRISMA ScR checklist in this scoping review. A mixed stakeholder group of patients and healthcare professionals identified 16 questions of importance to which the literature was mapped. An a-priori search strategy of both published and non-published material from five electronic databases and grey literature resources identified records. Two reviewers independently screened records for inclusion using explicit eligibility criteria with oversight from a third. Data extraction through narrative synthesis, charting and summary was performed independently by two reviewers. Results: Of 185 studies meeting eligibility criteria, diagnoses of wrist pain, De Quervain's syndrome and ulna-sided pain were encountered most frequently, with uncontrolled non-randomised trial or cohort study being the most frequently used methodology. Diagnostic methods used included subjective questioning, self-reported pain, palpation and special tests. Best practice guidelines were found from three sources for two NTWD conditions. Seventeen types of conservative management, and 20 different patient-reported outcome measures were suggested for NTWD. Conclusion: Substantial gaps in evidence exist in all parts of the patient journey for NTWD when mapped against an analytic framework (AF). Opportunities exist for future rigorous primary studies to address these gaps and the preliminary concerns about the quality of the literature regarding NTWD. [ABSTRACT FROM AUTHOR]

Objective: To compare painting related variables for carpal tunnel syndrome (CTS) and musculoskeletal wrist pain among students of calligraphy and figurative painting. Methodology: A comparative cross-sectional study was conducted on 212 participants from 21 January to 25 May 2023. The data was collected from the fine arts departments of public and private universities in Sialkot, Pakistan. Phalen’s clinical test was used to screen the CTS and Boston carpal tunnel questionnaire was used as an outcome measuring tool. SPSS version 22 was used to analyze the data. Mean, Standard deviation and Independent-t-test was used to compare the groups at significance level (p=0.05). Results: Out of 212, (N=148, 69.81%) were participants in figurative painting (group A) and (N=64, 30.18%) were in calligraphy (group B) with positive Phalen test. The total mean score of symptom severity scale for CTS was (26.49 ± 6.25) and functional status (21.26±7.58) which determines moderate difficulty with routine tasks. The symptom severity scale for CTS among groups A and B had mean scores (27.83 ± 6.20) and (23.40, ± 5.20) whereas the functional status scale among group A; had mean scores (23.20 ± 7.67) and B (16.79, ± 5.13) respectively. Factors that showed significant difference between painters and calligraphers BCTQ were working hours, medium of paints, size of paint brushes and types of paint brushes (p-value= 0.00). Conclusion: The results of this study showed an overall 'moderate' symptom severity and functional difficulty level among participants with CTS but figurative painters were more affected in some factors than calligraphers. Keywords: Painters, figurative, calligrapher, Carpal tunnel syndrome

Case: A 65-year-old man with chronic extensor carpi ulnaris (ECU) stenosing tenosynovitis who had failed treatments for 3 years was successfully treated with an ultrasound-guided retinaculum release of the sixth dorsal compartment. Conclusion: There are limited options in the literature for treating chronic, recalcitrant ECU tenosynovitis. We describe a novel technique in which the retinaculum overlying the ECU tendon was successfully incised under ultrasound guidance to release the sixth dorsal compartment stenosis. There was no recurrence of symptoms in the following 2 years of follow-up. [ABSTRACT FROM AUTHOR]

Background: The wrist is the most used site in operating the sewing machine. Sewing machine operators work continuously for long period of time. The repetitive movement on the wrist joint can cause pain. The acute wrist pain can affect the daily living activities. Objective: The objective of this study was to determine the effect of nerve gliding exercises and conventional treatment in reducing wrist pain among female sewing machine operators. Study type,settings& duration:The study was randomized controlled trial that was carried out at Government Polytechnic Institute for Women, Dandy School for Fashion Designing and Government Technical Training Institute for Women, Lahore from Februaryto August 2021. Methodology: Total of 66 female participants were randomly taken from different settings. Lottery method sampling technique was used to randomly place the 66 participants into two groups: group A (nerve gliding exercises) as treatmentgroup and group B (TENS forconventional treatment) as control group. The treatment was given for 4 weeks. The TENS was applied for 25-30mins with the frequency of 80-120Hz. Patient Related Wrist Evaluation questionnaire was used. The independent t-test and paired sample t-test was used for statistical analysis. Results:The group A (nerve gliding exercises) has pain relief score 34.14±7.69 whereas group B (conventional treatment) has pain relief score 38.58±10.14. The p-value obtained ˂0.05 was statistically significant in group A. This p-value shows that the treatment of group A was more effective than group B in reducing wrist pain in female sewing machine operators. Conclusion:This study concluded that nerve gliding exercises was more effective than conventional treatment for the reduction of wrist pain in female sewing machine operators.

Background and Objectives: Non-specific chronic wrist pain is wrist pain that occurs without a specific cause, such as trauma, and may limit the range of motion of the joints of the wrist and hand, affecting muscle strength, grip strength, and function. This study aimed to determine the effects of grip-strengthening exercises combined with wrist stability training on pain and function in patients with non-specific chronic wrist pain. Materials and Methods: The subjects of the study were 31 patients with wrist pain. To determine the effect of grip-strengthening exercises combined with wrist stability training, 15 participants participated in grip-strengthening exercises combined with wrist stability training and 16 control subjects participated. The experimental group participated in wrist-stability training. Grip-strengthening exercises combined with wrist stability training were performed for 20 min/day twice a week for 4 weeks, and relaxation massage and conservative physical therapy were performed for 20 min/day twice a week for 4 weeks. The control group received relaxation massage and conservative physical therapy for 40 min/day twice a week for 4 weeks. A visual pain scale was used to evaluate the degree of pain before and after treatment, and a patient-rated wrist evaluation was used to evaluate wrist function. Results: The results showed that the visual score significantly decreased in the time effect before and after the intervention in both groups (p < 0.001), patient-rated wrist evaluation significantly decreased (p < 0.001), and grip strength and muscle strength significantly increased (p < 0.001). The results of this study showed that grip-strengthening exercises combined with wrist stability training were effective in improving pain, function, grip strength, and muscle strength in patients with non-specific chronic wrist pain. Conclusions: Grip-strengthening exercises combined with wrist stability training can be used as an effective intervention method to improve pain, function, grip strength, and muscle strength, emphasizing the need for wrist exercise interventions in patients with non-specific chronic wrist pain in the future.

Background: The prevalence of wrist pain among gymnasts ranges from 46% to 79%. To alleviate wrist pain, gymnasts wear wrist guards/supports (WG/S). Purpose: To investigate the effect of WG/S on the wrist joint through joint moment, angles, total joint range of motion (ROM) arc, and ground-reaction force (GRF). Study Design: Controlled laboratory study. Methods: A cross-sectional study design was used to investigate 23 female gymnasts (mean ± SD: age, 12.3 ± 1.5 years; height, 143.4 ± 7.6 cm; mass, 37.7 ± 6.6 kg; body mass index, 18.6 ± 2.9) who performed back handsprings (analyzed by first half [phase 1] and second half [phase 2]) with the following 3 conditions: no WG/S, Skids/Ultimate Wrist Supports (S/UWS), and Tiger Paws (TP). Wrist joint moments, angles, total ROM arc, and GRF were examined by the 3 conditions using analysis of variance with Bonferroni correction and effect size (Cohen d). Results: For mean wrist flexion moment, both S/UWS and TP showed significantly higher values than the no-WG/S condition in landing phase 1 (S/UWS: P =.001, d = 1.30; TP: P =.019, d = 0.87). In angle comparisons in landing phase 1, no WG/S showed greater mean wrist extension angles compared with S/UWS (P =.046; d = 0.80), but no significant differences with TP (P =.096; d = 0.65). Also, in landing phase 1, total ROM arc of the right wrist was greater in the no-WG/S condition compared with S/UWS (P =.018; d = 0.88), but there were no differences with TP (P =.400; d = 0.52). Conclusion: These data show an increased wrist flexion moment using S/UWS and TP compared with the no-WG/S condition in landing phase 1 of back handsprings. Also, increased wrist extension angles and total arc ROM of the right wrist were found in the no-WG/S condition compared with S/UWS, but not with TP in landing phase 1. S/UWS may be helpful to reduce wrist joint angles, specifically wrist extension in landing phase 1, but both S/UWS and TP caused higher wrist flexion joint moment in landing phase 1. There were no differences found in GFG among the three variables. Clinical Relevance: In the first half of the back handspring, wrist guards can limit wrist extension joint angles and total arc ROM; however, an increased wrist flexion moment was found when wrist guards were worn, which may potentially lead to an increased risk of injury. Injury history, especially overuse signs/symptoms, and previous surgery on the wrist joint need to be well considered before the application or use of wrist guards. Also, the amount of time/exposure wearing wrist guards should be carefully controlled in young female gymnasts. [ABSTRACT FROM AUTHOR]

Ulnar wrist pain is a frequent symptom with many possible traumatic and non-traumatic causes. The complex anatomy and biomechanics of the wrist with the ulnocarpal complex including the triangular fibrocartilaginous complex (TFCC), the distal radio-ulnar joint (DRUJ) and the ulnar carpal bones make the differentiation between the possible causes difficult. A precise clinical investigation and appropriate imaging studies are essential for detecting the most important differential diagnoses, the first therapeutical steps and an early and appropriate referral to the hand surgeon. [ABSTRACT FROM AUTHOR]

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BackgroundProlonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort.ObjectiveTo survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures.MethodsBy using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ2 test was used to compare prevalence by selected factors, trend χ2 test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain.ResultsThere were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain.ConclusionAwkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.

Abstract Background Carpal Tunnel Syndrome (CTS) is the most prevalent peripheral nerve entrapment disease. Its pathophysiology is multifactorial and defined as idiopathic in most cases. We present a rare case of CTS secondary to tumoral calcinosis and then searched the English literature to present the details of all published cases with this entity. Case presentation. A 52-year-old woman presented for a one-year history of numbness and paresthesia in her right hand. The patient’s signs, symptoms, physical examination, and nerve electrodiagnostic testing suggested median nerve compression at the level of the carpal tunnel. However, a confirmatory magnetic resonance imaging of the wrist showed a localized calcareous lesion in the carpal tunnel. Subsequently, carpal tunnel release and mass excision were successfully performed with no recurrence at a 3-month interval. Conclusion CTS secondary to tumoral calcinosis is a rare benign condition. Physicians should remain vigilant and include it in their differential diagnosis when facing a previously healthy patient presenting for chronic CTS symptoms.

Background: The wrist is the most used site in operating the sewing machine. Sewing machine operators work continuously for long period of time. The repetitive movement on the wrist joint can cause pain. The acute wrist pain can affect the daily living activities. Objective: The objective of this study was to determine the effect of nerve gliding exercises and conventional treatment in reducing wrist pain among female sewing machine operators. Study type, settings & duration: The study was randomized controlled trial that was carried out at Government Polytechnic Institute for Women, Dandy School for Fashion Designing and Government Technical Training Institute for Women, Lahore from February to August 2021. Methodology: The study design was Randomized control trial. Total of 66 female participants were randomly taken from different settings. Lottery method sampling technique was used to randomly place the 66 participants into two groups: group A (nerve gliding exercises) as treatment group and group B (TENS for conventional treatment) as control group. The treatment was given for 4 weeks. The TENS was applied for 25-30 mins with the frequency of 80-120Hz. Patient Related Wrist Evaluation questionnaire was used. The independent t-test and paired sample t-test was used for statistical analysis. Results: The group A (nerve gliding exercises) has pain relief score 34.14±7.69 whereas group B (conventional treatment) has pain relief score 38.58±10.14. The p-value obtained 0.05 was statistically significant in group A. This p-value shows that the treatment of group A was more effective than group B in reducing wrist pain in female sewing machine operators. Conclusion: This study concluded that nerve gliding exercises was more effective than conventional treatment for the reduction of wrist pain in female sewing machine operators. [ABSTRACT FROM AUTHOR]

Les douleurs du poignet sont un symptôme fréquent touchant les pratiquants de sports de raquettes, golf, gymnastique, cyclisme dans lesquels l'utilisation des mains est importante. Les douleurs du poignet du sportif peuvent être causées par un traumatisme aigu ou des microtraumatismes chroniques avec répétition de contraintes sur les tendons, ligaments et les structures articulaires. Dans cet article, nous décrirons les mécanismes menant aux lésions microtraumatiques du poignet, les lésions spécifiques du versant ulnaire et radial avec les diagnostics différentiels, les examens d'imagerie et les principes de traitement. Wrist pain is a common symptom affecting athletes in racket sports, golf, gymnastics, cycling where there is frequent use of the hands. Wrist pain in athletes can be related to acute trauma or chronic overuse with repetitive stresses to tendons, ligaments, and the joint structures. In the present article, we discuss mechanisms of overuse wrist injury, sport-specific ulnar-sided and radial-sided wrist injuries with differential diagnosis, imaging and principles of treatment. [ABSTRACT FROM AUTHOR]

Background: Pain of the hand and wrist affects a large patient population. If the onset is unrelated to recent trauma, the first medical contact is rarely established with a specialized hand surgeon. Objective: The objective of this investigation was to (1) visualize the localization of hand pain using pain-related heatmaps in common wrist pathologies, (2) to test whether differences between these pathologies exist with regard to sociodemographic and pain-related aspects, and (3) to evaluate the major patient-reported complaints associated with the pathologies. Methods: This observational cross-sectional study included patients suffering from: thumb basal joint arthritis (CMC-1-OA), dorsal wrist ganglions, and TFCC tears. Patients marked the location of maximum pain projection on hand graphics depicting the outline of the palmar and dorsal hand. Color-graded frequency heat maps were generated for the wrist pathologies investigated. Daily life impairments were assessed and clustered into groups of functions/activities. Results: 120 patients with a mean age of 44.3 years were investigated. The diagnostic groups showed significant differences regarding the level and location of pain, as well as daily life impairments. Patients with CMC-1-OA presented with increased pain levels compared to patients with dorsal wrist ganglions and TFCC tears. Daily life impairment was rated highest when household chores were adversely affected, and sport activities were symptomatic/painful. All groups showed significant skin surface pain projection, which was visualized in heatmaps. While general trends in pain localization were visible, pain levels were also reported distal/proximal and palmar/dorsal to the pathology. Conclusions: Knowledge of main demographic parameters, pain projection, and degree of impairment in daily activities can help physicians to narrow differential diagnosis of wrist pain during first patient contact. Patients should then be referred to hand surgeons for specialist examination, to further differentiate the origin of the pain. [ABSTRACT FROM AUTHOR]

Objectives. Hand block printing is a highly repetitive and precision job involving tasks such as hitting the wooden hand block with the hands as a hammer, causing chronic mechanical trauma to the ulnar side of the palm. This study aimed to determine the prevalence of work-related hand symptoms, to identify ergonomic risks and musculoskeletal disorders (MSDs) and evidence of mechanical trauma among artisans working in Bagh print of Madhya Pradesh. Methods. Occupational risk involved in the artisan's wrist area was identified using the modified Dutch musculoskeletal questionnaire (MDMQ) and modified Boston hand evaluation questionnaire. The Boston hand evaluation questionnaire helps in the measurement of the severity of the symptoms. A direct observation study was performed to identify the chronic effects of mechanical trauma (CEMT) on artisan's hands. Results. Symptoms like pain, weakness, numbness and tingling were highly prevalent among the artisans, those with experience <3 years were more likely to report pain during working hours (p < 0.001) and those with experience >13 years were more likely to report numbness (p < 0.001) and tingling (p < 0.001). Conclusion. This study supports the evidence that the new artisans are at higher risks of reporting pain and CEMT, including fever and body pain, ultimately causing job loss. [ABSTRACT FROM AUTHOR]

Purpose: Chronic, nonspecific wrist pain in adolescents can be challenging to assess and treat. We hypothesized that an algorithmic approach beginning with grip strengthening can alleviate pain, improve function, and identify patients in need of further intervention. Methods: We retrospectively reviewed the results of a grip-strengthening protocol for adolescents with chronic, nonspecific wrist pain. Before and after treatment, grip strength was measured using handheld dynamometry, and patient-reported pain and function were measured using the adolescent self-reported Pediatric Outcomes Data Collection Instrument’s (PODCI’s) Pain/Comfort and Upper Extremity Function domains (PODCI/pain and PODCI/UE, respectively). Results: Thirty-two patients (28 female, 4 male) were included, with a mean age of 14 years (range, 10–18 years) and the dominant hand affected in 19, nondominant hand in 9, and bilateral impacts in 4. The mean symptom duration prior to presentation was 9 months (range, 1–63 months); 17 patients had undergone prior immobilization and 5 prior occupational/physical therapy. Grip-strengthening treatment, lasting a mean of 40 days (range, 21–82 days) with a median of 4 therapy visits (range, 2–6), was associated with significantly improved grip strength (mean, 32–48 lbs), PODCI/pain scores (mean, 49.0–78.2 points), and PODCI/UE scores (mean, 78.2–91.2 points). Improvements in grip strength correlated with improvements in PODCI/pain and PODCI/UE scores (r = 0.64 and 0.70, respectively). Eight patients (25%) had either no or incomplete pain relief: 5 underwent successful further intervention (2 ganglion cyst excisions, 1 triangular fibrocartilage complex repair, 1 arthroscopic debridement, 1 steroid injection), 2 received ongoing pain management for generalized pain syndromes, and 1 was lost to further follow-up. No pretreatment variables were identified that predicted failure. Conclusions: Grip strengthening relieves pain and improves function in the majority of adolescents with chronic, nonspecific wrist pain. Systematic use of this protocol helps to identify patients who require further intervention. Type of study/level of evidence: Therapeutic IV.

Musculoskeletal disorders (MSDs) are the most common occupational illnesses in the world. Dental professionals are more prone to injuries and pain in their muscles, tendons, nerves, and joints, which are known as MSDs. Prolonged static postures, repeated actions, workplace designs, poor alignment, genetic predisposition, mental stress, physical conditioning, age, and nonwork activities are all factors that might contribute to musculoskeletal pain (MSP). This systematic review and meta-analysis was based on Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and the articles were retrieved from the search engines such as PubMed, Google Scholar, and Web of Science after fulfilling the eligibility criteria. After screening, a final of ten articles were included in the final analysis. This systematic and meta-analysis follows the PRISMA checklist. Medcalc software was used in order to find the significance of the prevalence of lower back pain, followed by neck pain, upper back pain, shoulder pain, and hand and wrist pain in dental practitioners. Significant differences were considered at P < 0.05. A total of ten studies were included, of which six studies met the criteria for the meta-analysis. The prevalence rates of musculoskeletal diseases were high. The lower back was the region most affected (47.753%, 95% confidence interval [CI]: 45.007–50.509), followed by the upper back body region (44.167%, 95% CI: 41.300–47.063%), neck pain (41.633%, 95% CI: 39.066%–44.234%), shoulder pain (33.608%, 95% CI: 31.222%–36.058% and 18.656%), and hand/wrist pain (95% CI: 16.359%–21.128%). Work-related MSP is the major health problem among dental professionals. Working posture of dental professionals is important and has been identified as a major risk factor for the development of work-related MSDs. A proper ergonomic design and posture can reduce the MSP. Therefore, further research is needed on possible ergonomics needed for preventing MSDs.

Osteoarticular tuberculosis of the wrist is a very rare subset of skeletal Tuberculosis. Diagnosing the tuberculosis wrist in its early stage poses a major challenge to the clinicians because of its atypical and vague presentations and a close resemblance to many relatively benign pathologies. Clinicians from developed parts of the world having less exposure to the myriad forms of osteoarticular tuberculosis are more likely to miss it. We hereby report one such case who presented with wrist pain of short duration, which after thorough examination and investigations, turned out to be tuberculous. It was successfully managed with anti-tuberculosis drugs alone without any debridement or synovectomy. Familiarity with the clinical profile of this entity, in its early stages, is valuable for primary care physicians, rheumatologists, internal medicine specialists, and orthopaedicians alike, who may confuse it with one of the many more common inflammatory, degenerative, or traumatic causes of wrist pain. Within normal range or near normal erythrocyte sedimentation rate and C-reactive protein, and normal looking X-ray does not preclude the diagnosis of tuberculosis wrist. The role of a high index of suspicion and a low threshold for getting higher radiological investigation like MRI in non-responding cases of wrist joint pain cannot be overstated.

Background: Carpal Tunnel Syndrome (CTS) is the most prevalent peripheral nerve entrapment disease. Its pathophysiology is multifactorial and defined as idiopathic in most cases. We present a rare case of CTS secondary to tumoral calcinosis and then searched the English literature to present the details of all published cases with this entity.Case Presentation: A 52-year-old woman presented for a one-year history of numbness and paresthesia in her right hand. The patient's signs, symptoms, physical examination, and nerve electrodiagnostic testing suggested median nerve compression at the level of the carpal tunnel. However, a confirmatory magnetic resonance imaging of the wrist showed a localized calcareous lesion in the carpal tunnel. Subsequently, carpal tunnel release and mass excision were successfully performed with no recurrence at a 3-month interval.Conclusion: CTS secondary to tumoral calcinosis is a rare benign condition. Physicians should remain vigilant and include it in their differential diagnosis when facing a previously healthy patient presenting for chronic CTS symptoms. [ABSTRACT FROM AUTHOR]

Adolescence is a difficult time, both physically and emotionally. Rapid growth coupled with physical changes in the background of high levels of activity can be overwhelming. Meanwhile, unfamiliar life stressors coupled with undeveloped compensatory mechanisms can lead to overwhelming anxiety and emotional distress. Emotional factors can make injuries and overuse syndromes feel more catastrophic. Occasionally, an adolescent's emotional distress can manifest physically, without antecedent injury or physiologic cause. Understanding the psychological milieu is as important as understanding the disease processes that can affect adolescents if one hopes to manage these patients effectively. [ABSTRACT FROM AUTHOR]