Pain on the radial side of the wrist

Introduction The degenerative changes of the finger joints in the distal interphalangeal joints of Heberden"s nodules occur in the middle finger and index finger, the proximal interphalangeal joints of the Bouchard's nodules are less common, often mistaken for rheumatoid nodules, the first Degenerative changes in the metacarpophalangeal joint can cause pain in the temporal side of the wrist joint, and other metacarpophalangeal joints are rarely involved.

Cause

Causes of pain in the temporal side of the wrist:

A variety of factors cause joint disease caused by fibroplasia, cleft palate, ulceration, and loss of articular cartilage. The cause is not clear, and its occurrence is related to age, obesity, inflammation, trauma and genetic factors. Its pathological features are degeneration of articular cartilage, subchondral bone sclerosis or cystic changes, joint bone hyperplasia, synovial hyperplasia, joint capsule contracture, ligament relaxation or contracture, muscle atrophy and so on.

an examination

Related inspection

Bone imaging and joint MRI examination

Examination and diagnosis of pain in the temporal side of the wrist:

The routine examination of hematuria and erythrocyte sedimentation rate, mucin, and rheumatoid factor in the patient's disease are in the normal range. The synovial fluid was tested for color, transparency and mucin clot test. The white blood cell count was between 200 and 2000/mm3. There was no bacteria or crystallography on the microscopic examination, but cartilage fragments and fibers were visible. The number of fragments could be used to roughly estimate cartilage degradation. degree.

X-ray plain films generally have typical manifestations, mainly narrow joint space, subchondral bone sclerosis, marginal lip-like changes and osteophyte formation, and intracapsular cystic changes around the joint. In addition to the above changes in the spine, such as the nucleus pulposus protruding into the upper and lower vertebral bodies to form subchondral nodules, the so-called Schmorl's nodes (Schmorl's nodes), sometimes must be differentiated from spinal space-occupying lesions.

CT and MRI examination can clearly show joint lesions, disc herniation, thickening of calcification of posterior longitudinal ligament, etc., which has diagnostic significance for osteoarthritis.

Differential diagnosis

Differential diagnosis of pain in the temporal side of the wrist:

(1) Degenerative changes of the finger joints in the distal interphalangeal joints of the Heberden"s nodules occur in the middle finger and index finger, the proximal interphalangeal joints of the Bouchard's nodules are less common, often mistaken for rheumatoid Summary, the degenerative changes of the first metacarpophalangeal joint can cause pain in the temporal side of the wrist joint, and other metacarpophalangeal joints are rarely involved. The occurrence of Heberden's nodules is related to heredity and gender. Most women are seen, most of them have no obvious pain, but they may have inconvenient movement and mild numbness, and may cause distal interphalangeal joint flexion and skew deformity, and some development. Faster patients (often in excessive exertion) may have acute redness and pain.

(B) primary knee osteoarthritis affects the knee joint is the most common. The patient often complains that the joint has a click sound, feels pain when walking, and improves after a break. When the sedentary is standing for a long time, the joint is stiff, and walking and relaxing the muscle can make the stiffness disappear. The symptoms are light and heavy, and even different every day. Joint swelling is often caused by bone hyperplasia, and can also be caused by a small amount of exudate. Acute swelling suggests intra-articular bleeding. Limited knee joint activity during the progression of the disease can cause disuse muscle atrophy and even knee valgus or varus deformity.

(3) There are two sets of joint devices in the spine spine, namely the intervertebral disc and the superior and inferior articular joints. There are hook joints (Lushka joints) in the cervical vertebrae 2-7. Most of the primary ones are due to degeneration of the intervertebral disc, dehydration of the nucleus pulposus, stenosis of the intervertebral space, and osteophyte hyperplasia. Most of them have no clinical manifestations. If symptoms are different, most of them are chronic diseases. However, it sometimes causes an acute attack due to injury, weight lifting, sudden movement of the spine, and the like. In the cervical vertebrae, the epiphysis at the edge of the hook joint can cause the cervical nerve root to be squeezed when it is worn away from the intervertebral foramen, and the recurring neck pain can be radiated to the forearm and fingers, and there can be finger numbness and activity. . The epiphysis of the posterior edge of the vertebral body can protrude into the spinal canal and squeeze the spinal cord, causing the lower limbs to be numb, weak, and even quadriplegia. When the vertebral artery is compressed, there may be a manifestation of insufficient blood supply to the basilar artery. Degenerative changes in the thoracic spine occur less frequently. In the lumbar vertebrae, lumbar 4 ~ 5, waist 5 ~ 1 is the most prone to intervertebral disc herniation, the main symptoms are low back pain with sciatica, often after sprains, lifting heavy objects, bending and exerting force, physical examination local tenderness, straight leg High test positive, can have changes in sensation, muscle strength and tendon reflex.

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