Article thumbnail

Ulnar-sided wrist pain. Part I: anatomy and physical examination

By Peter S. Vezeridis, Hiroshi Yoshioka, Roger Han and Philip Blazar


Ulnar-sided wrist pain is a common complaint, and it presents a diagnostic challenge for hand surgeons and radiologists. The complex anatomy of this region, combined with the small size of structures and subtle imaging findings, compound this problem. A thorough understanding of ulnar-sided wrist anatomy and a systematic clinical examination of this region are essential in arriving at an accurate diagnosis. In part I of this review, ulnar-sided wrist anatomy and clinical examination are discussed for a more comprehensive understanding of ulnar-sided wrist pain

Topics: Review Article
Publisher: Springer-Verlag
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (1997). A comparison of magnetic resonance imaging and arthroscopy in the investigation of chronic wrist pain. J Hand Surg [Br].
  2. Anatomic study of arborization patterns of the ulnar artery in Guyon’s canal.
  3. (1986). Arterial anatomy of the triangular fibrocartilage of the wrist and its surgical significance. J Hand Surg [Am].
  4. (1987). Chronic ulnar wrist pain secondary to partial rupture of the extensor carpi ulnaris tendon. J Hand Surg [Am].
  5. Chronic wrist pain: evaluation with high-resolution MR imaging.
  6. (2003). Clinically significant skeletal variations of the shoulder and the wrist: role of MR imaging. Eur Radiol.
  7. Correlation of clinical and radiographic findings in Kienbock’s disease.
  8. (1989). Detailed anatomy of the articular disc of the distal radioulnar joint. Clin Orthop Relat Res.
  9. Diagnosis of ulnar wrist pain.
  10. Direct arthrography of the pisotriquetral joint.
  11. (2001). Distal radioulnar joint arthrography for detection of deep portion tears of the triangular fibrocartilage complex. J Jpn Soc Surg Hand.
  12. (1996). Distal ulnar injury and dysfunction.
  13. (2010). Dysfunction of the pisotriquetral joint: treatment by excision of the pisiform.
  14. (1987). Ergonomics considerations in hand and wrist tendinitis. J Hand Surg [Am].
  15. (2004). Extensor carpi ulnaris subluxation or dislocation? Ultrasound measurement of tendon excursion and normal values. Hand Surg.
  16. (1970). Extensor carpi ulnaris. Its relationship to the stability of the distal radio-ulnar joint. Clin Orthop Relat Res.
  17. (2007). Factors affecting results of ulnar shortening for ulnar impaction syndrome. Clin Orthop Relat Res.
  18. (1990). for Surgery of the Hand. The hand: examination and diagnosis. 3rd ed.
  19. (1988). Fractures and dislocations of the distal radioulnar joint. Hand Clin.
  20. (2006). High-resolution MR imaging of the proximal zone of the lunotriquetral ligament with a microscopy coil. Skeletal Radiol.
  21. Imaging findings in ulnar-sided wrist impaction syndromes.
  22. (1998). Kienbock disease and negative ulnar variance.
  23. Kienbock’s disease.
  24. (2008). Ligamentous injuries of the wrist. Semin Musculoskelet Radiol.
  25. (1995). Lunate morphology: can it be predicted with routine X-ray films? J Hand Surg [Am].
  26. (1992). Lunate-triquetral and midcarpal joint instability. Hand Clin.
  27. Lunotriquetral interosseous ligament of the wrist: MR appearances in asymptomatic volunteers and arthrographically normal wrists.
  28. Lunotriquetral sprains.
  29. (1998). Mechanical strain at the pisotriquetral joint. Clin Anat.
  30. (1999). MR imaging of the type II lunate bone: frequency, extent, and associated findings.
  31. (1994). Negative ulnar variance is not a risk factor for Kienbock’s disease. J Hand Surg [Am].
  32. (1951). Osteoarthritis of the pisiform-triquetral joint; report of three cases.
  33. (1976). Physical examination of the spine and extremities.
  34. Pisotriquetral arthritis: a case report.
  35. Pisotriquetral joint: assessment with MR imaging and MR arthrography.
  36. Posttraumatic recurrent subluxation of the extensor carpi ulnaris tendon.
  37. (1981). Recurrent dislocation of extensor carpi ulnaris tendon. J Hand Surg [Am].
  38. Recurrent dislocation of the extensor carpi ulnaris in athletes.
  39. SacharK.Ulnar-sidedwristpain:evaluationandtreatmentoftriangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears.
  40. (1986). Stenosing tenosynovitis of the extensor carpi ulnaris. J Hand Surg [Am].
  41. Study of ulnar variance with high-resolution MRI: correlation with triangular fibrocartilage complex and cartilage of ulnar side of wrist.
  42. The “ulnar fovea sign” for defining ulnar wrist pain: an analysis of sensitivity and specificity.
  43. (2002). The hamatolunate facet: characterization and association with cartilage lesions–magnetic resonance arthrography and anatomic correlation in cadaveric wrists. Skeletal Radiol.
  44. (1991). The influence of age and sex on ulnar variance. J Hand Surg [Br].
  45. (1991). The ulnar impaction syndrome. Hand Clin.
  46. (1992). The ulnar tunnel at the wrist (Guyon’s canal): normal MR anatomy and variants.
  47. (1997). The ulnocarpal stress test in the diagnosis of ulnar-sided wrist pain. J Hand Surg [Br].
  48. Thetriangularfibrocartilage complexofthe wrist—anatomy and function.
  49. (1989). Triangular fibrocartilage complex lesions: a classification. J Hand Surg [Am].
  50. (2006). Triangular fibrocartilage complex tears: a review. Bull NYU Hosp Jt Dis.
  51. Triangular fibrocartilage in asymptomatic subjects: investigation of abnormal MR signal intensity.
  52. (1996). Ulnar impaction syndrome: MR imaging findings.
  53. Ulnar midcarpal instability—clinical and laboratory analysis.
  54. Ulnar variance in Kienbock’s disease.
  55. (1998). Ulnar-sided wrist pain in athletes. Clin Sports Med.
  56. (1996). Update on imaging techniques of the wrist and hand. Clin Plast Surg.
  57. (2001). What happens to the triangular fibrocartilage complex during pronation and supination of the forearm? Analysis of its morphology and diagnostic assessment with MR arthrography. Skeletal Radiol.
  58. (1993). Wrist anatomy: incidence, distribution, and correlation of anatomic variations, tears, and arthrosis. J Hand Surg [Am].