Wrist Note

Occupation:
Sport:
Involved Side:
Injury:
HPI: 45y/o RHD female with gradually worsening right wrist pain over several months. 3-7/10 dorsal wrist pain. Worse with activity such as push-ups, and getting up from chairs. Noted lump on wrist several months ago. No recent changes in size. Previous treatment: NSAIDs, no aspirations, no brace, no PT, no surgeries.
PMH:none
PSH:none
Medications: none
Allergies: none
SH: no tob, no ETOH
ROS: no fever, no chills, no drastic changes in weight, no bleeding problems, no metal allergies
PHYSICAL EXAM
HT: Wt:
compressible, transilluminating, slightly mobile mass dorsal wrist without skin changes
wrist extension elicits pain
Tenderness: none
Resisted wrist and finger extension with the elbow in full extension exacerbates pain
No pain on resisted suppination (PIN irritation).
Flexion(R/L): 55 / 55
Extension (R/L): 45 / 45
Radial deviation (R/L): 12 / 12
Ulnar deviation (R/L): 30 / 30
able to A-OK, hook horns, cross fingers, thumbs up
subjective normal M/U/R distal sensation
2+ Radial pulse
Xray: no osseous deformity
MRI: none
ASSESSMENT: ()
Discussed natural history, operative and non-operative treatments; risks, benefits and expected rehab course of each. All questions answered.
Cyst aspirated under sterile technique, no complications
activity modifications
Cock-up wrist splint
NSAIDS
Information sheet given
Follow-up 6-8 weeks