Question

Nancy, 34, has developed joint pain in both wrists. They are both swollen and she can hardly move them. X-rays reveal that the certain carpal bones have fused. She reports that the pain will come and go. What do you think the most probable cause of her problem is and what initial course of treatment will her physician recommend?

Answer 1

The most probable cause is due to Carpal coalition. It is the fusion of two or more carpal bones.

Causes of Carpal coalition are:

• Mendelian inheritance pattern.
• Inflammatory arthropathy
• Rheumatoid arthritis
• Psoriatic arthritis
• Reactive arthritis
• Injury
• Intentional surgical arthrodesis.

Treatment:

• Non-steroidal anti-inflammatory drugs (nsaids)
• Steroidal anti-inflammatory injection
• Analgesics
• Generally, it does not cause unease or discomfort for the patient or impair wrist function thus treatment is not needed.
• If it causes persistent pain, arthrodesis or the introduction of a joint via surgery can be performed.