Radial styloid pain

Introduction The stenotic tenosynovitis of the sacral styloid process is mainly characterized by localized pain in the styloid process of the tibia. The onset of the disease is slow and gradually worsened. There is a pain in the bony process (stem of the humerus) and the thumb around the thumb. The thumb is blocked, and there is tenderness and friction in the styloid process of the humerus. Sometimes there is a styloid process in the humerus. Slightly uplifted pea-sized nodules. If the thumb is gripped in the other four fingers and the wrist is flexed to the inside of the wrist (the ulnar side), severe pain occurs at the styloid process of the humerus. In the acute phase, there may be local swelling. When the swollen tendon passes through the "tunnel" of the narrow tendon sheath, the sound of the thumb will occur when it is in the middle of the bend, which is also known as the "snap finger".

Cause

A strong ligament (extensor support band) adheres to the concave surface of the styloid process stump to form a sheath. Among them, the flexor hallucis longus muscle and the extensor pollicis longus extensor muscle pass. The thumb plays an important role in the function of the hand. When the labor of the hands and wrists suddenly increases, the tendons and sheaths can be damaged and pain can occur.

an examination

Related inspection

X-ray lipiodol imaging of bone and joint plain films of limbs

The main manifestation is pain in the wrist, which can be radiated to the hands and forearms. The thumb is weak. The pain is obvious when pouring the thermos. There are bounces and locks.

Locally visible small bulges, and can reach small induration, tenderness.

The Finkelstein test is a fist-to-handle experiment: the thumb is held in the palm of the hand, then the fist is made, and the wrist is gently erected. The sacral styloid process is positive for severe pain.

Differential diagnosis

Differential diagnosis:

Severe pain of the sacral styloid process: patients with tendonitis of the sacral styloid process, the fist scapular test (Fin kelstain sign) is often positive: the thumb is held in the palm of the hand, the fist is fisted, the wrist joint is flexed to the ulnar side, and there is a severe pain in the styloid process of the humerus. .

Wrist pain: Wrist pain caused by wrist injuries, arthritis, tendinitis and other diseases. Wrist sprains, with a significant history of trauma. After the injury, the wrist is weak and the wrist is not active. Minor injuries, generally no obvious swelling, pain is not very good, only when there is a large movement of the wrist joints began to have pain. Severe sprains may cause swelling of the wrist, severe pain, and increased pain when the wrist or movement is not active. During the examination, the wrist joint is flexed and the pain is on the dorsal side, which indicates that the dorsal ligament of the wrist and the wrist extensor tendon are damaged; otherwise, the ligament of the wrist or the flexor tendon of the wrist is damaged. If the wrist joint is deflected to the ulnar side, and the pain occurs in the styloid process of the humerus, the collateral ligament injury is caused; otherwise, the ulnar collateral ligament is damaged. If there is pain in the movements of the wrist in all directions, and the activity is obviously limited, it means a composite injury of ligaments, tendons and the like. There is tenderness in the lesion or abnormal changes in the tissue of the tendon. Wrist injuries should be treated promptly to prevent ischemic necrosis of the wrist scaphoid and wrist and lunate bone.

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