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Dorsal intercalated segment instability (DISI) is a deformity of the wrist where the lunate bone angulates to the dorsal side of the hand. [2] [3] Causes
Swelling and displacement can cause compression on the median nerve which results in acute carpal tunnel syndrome and requires prompt treatment. Very rarely, pressure on the muscle components of the hand or forearm is sufficient to create a compartment syndrome which can manifest as severe pain and sensory deficits in the hand.
Any movement of the thumb and wrist causes the patient pain, inflammation and swelling. The presence of anomalous or variant muscles in the fourth compartment may result in chronic dorsal wrist pain, a condition known as the fourth compartment syndrome. [4] Intersection syndrome can be caused by direct trauma to the second extensor compartment.
Symptoms such as swelling in the hand can be mitigated via consumption of corticosteroids. [ 12 ] In the case of rheumatoid arthritis, a specific class of drugs known as disease-modifying anti-rheumatic drugs (DMARDs) can be utilised for helping reduce joint damage.
Carpal tunnel as seen on MRI. The carpal bones that make up the wrist form an arch which is convex on the dorsal side of the hand and concave on the palmar side. The groove on the palmar side, the sulcus carpi, is covered by the flexor retinaculum, a rigid band of fibrous tissue, thus forming the carpal tunnel.
In human anatomy, the dorsal interossei (DI) are four muscles in the back of the hand that act to abduct (spread) the index, middle, and ring fingers away from the hand's midline (ray of middle finger) and assist in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints of the index, middle and ring fingers. [1]
The theory is that the radial nerve becomes irritated and/or inflamed from friction caused by compression by muscles in the forearm. [1]Some speculate that radial tunnel syndrome is a type of repetitive strain injury (RSI), but there is no detectable pathophysiology and even the existence of this disorder is questioned.
Commonly, wrist pain is caused by sudden load-bearing or twisting effects, such as falling from a height with an outstretched hand. [1] Rupture of multiple wrist ligaments in a more severe event may require surgical repair. [1] Injury to and inflammation of the scapholunate ligament is a common wrist injury. [1]