Wrist Arthritis 715.13

 

synonyms:

Wrist Arthritis ICD-9

  • 715.13 (osteoarthritis localized, primary, forearm)

Wrist Arthritis Etiology / Epidemiology / Natural History

Wrist Arthritis Anatomy

  • Distal radius carries 80% of axial load
  • ROM-80°dorsiflexion, 85°palmarflexion, 90°pro\sup,25°radial deviation,35°ulnar deviation
  • Distal radius 3 column anatomy: Radial column (strong cortical bone), Intermediate column (contains lunate facet and sigmoid notch); Distal ulna column (contains TFCC) (Rikle DA, JBJS 1996;78Br:588)
  • Radial inclination=23°,radial length=12mm, volar tilt=11°, ulnar variance -0.6mm, scapholunate angle = 60° +/-15°. (Medoff RJ, Hand Clin 2005;21:279)
  • Sensory branch of radial nerve becomes subcutaneous 5-10cm proximal to radial styloid in interval between brachioradialis and ECRL. It bifurcates before wrist. Dorsal branch 1-3cm radial to Listers. Supplies 1st and 2nd web spaces. Palmar branch passes within 2cm of 1st dorsal compartment provides sensation to dorsolateral thumb after passing directly over EPL.
  • Palmar cutaneous branch of the Median nerve arises from the Median nerve @4-6cm proximal to the volar wrist crease and travels between the FCR and median nerve. Supplies sensation to the thenar area.
  • Dorsal cutaneous branch of ulnar n arises deep to FCU, becomes SQ 5cm from pisiform-has multiple branches

Wrist Arthritis Clinical Evaluation

  • Pain and swelling in wrist often have history of distal radius fracture or inflammatory arthritis
  • Document neurovascular exam
  • Evaluated for carpal tunnel syndrome

Wrist Arthritis Xray / Diagnositc Tests

  • PA, Lateral wrist films. Normal radiographic parameters: Radial inclination=23°,radial length=12mm, volar tilt=11°, scapholunate angle = 60° +/-15°. Assess ulnar variance, carpal alignment and sigmoid notch conguence
  • Knirk and Jupiter OA Grading (Knirk JL, JBJS 1986;68:647)
    Grade 0: no arthritis
    Grade 1: slight joint space narrowing
    Grade 2: marked joint space narrowing with osteophyte formation
    Grade 3: bone on bone with osteophyte and cyst formation

Wrist Arthritis Classification / Treatment

Wrist Arthritis Associated Injuries / Differential Diagnosis

Wrist Arthritis Complications

Wrist Arthritis Follow-up Care

Wrist Arthritis Review References

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