mid carpal instability

Hi

I am new to this site and came across it when doing a google search for mid carpal instability.

I have had wrist pain for a couple of years now with no cause factor with both wrists affected (right more than left).

Physiotherapy didn't help and nor did steroid injections (apart from a few weeks relief) and splinting was also little help but very limiting.

Last year after xrays, MRI and an arthroscopy my consultant diagnosed R wrist dequervains tendinitus and arthritis along my carpal bones (especially scaphoid, trapezium and trapezoid).

This resulted in me having a dequervains release and a joint replacement of the STT joint.

Now nearly a year later my wrist movement is approximately half of what it should be and all movement of the wrist towards the end of range is painful, as is lifting any weight and I have very weak grip strength.

This consultant had all but given up on me not knowing why my movement and pain hadn't improved but referred me to another consultant.

I saw this consultant today and he mentioned that I may well have mid carpal instability and is planning another MRI to try to confirm it and plan future treatment.

It has been a great help to read all the information you have posted on here and to hear other people's stories.

It is so limiting to have this almost constant pain in your wrists it has affected me and my life so profoundly in a way I do believe others fully understand.

Thank you for providing me with what I needed just now. Julie<br><br>Post edited by: Scott_1984, at: 2008/01/29 16:46

Hiya Julie

This is an excellent website creadted by Karl Dean &amp; I run 2 forums on Ablehere.Com - RSD/CRPS &amp; Carpal Instability Support &amp; Depression/Mental Health Issues.

I am very glad you've found this website &amp; these forums

I'm a Mid Carpal Instability (MCI) suffer in my left hand/wrist &amp; I Completely understand the Pain/Discomfort, Clunking, Snapping, &amp; Popping/Clicking movements/sensations, &amp; disability it causes.

Another way to see if you have Mid Carpal Instability (Carpal Instability), without having another Wrist Arthroscopy Surgery, is to ask for an detailed VideoFluoroscopy &amp; Stress X-Rays of both your hands/wrists to see if you suffer from Mid Carpal Instability (Carpal Instability).

Most soft tissue injuries/disablities will never show up on plan X-rays &amp; they will only be obvious like in 5 - 10 years time, when the bones/joints have moved totally out of place or normal range.

So in other words soft tissue will never show up on a plan X-rays &amp; its only years later that the hospital might notice there could be a soft tissue injury/disability, as all the bones have moved out of normal range/aliment.

Wrist Instability/Carpal Instability (MCI/PMCI) Chat: www.ablehere.com/component/option,com_jo...iew/id,1974/catid,47

What Is Midcarpal Instability (Wrist Instability/Carpal Instability)?: www.ablehere.com/component/option,com_jo...iew/id,1162/catid,47

Post edited by: Scott_1984, at: 2008/01/27 05:18

Hiya Julie

Your new surgeon might suggest, another Wrist-Arthroscopy for this surgeon to diagnosis the levels of Wrist Instability Patterns, he may also seek for an detailed VideoFluoroscopy, Stress X-rays, &amp; possible an MRI-Scan.

Most MRI-Scans are Pointless in detecting soft tissue damage/Carpal Instability in your hands/wrists.

So the gold standard for detecting &amp; diagnosing Carpal Instability is: Wrist Arthroscopy &amp; Physical Eaxminations/Tests of the hands/wrists, &amp; these Physical Eaxminations/Tests won't be very nice, but I'am sure you may have had some of these carried out before.

One Eaxmination/Test for Wrist Instability Is: Watson's Test: en.wikipedia.org/wiki/Watson%27s_test

This Website Show An Series Of Ways For Detecting &amp; Diagnosing Wrist Instability/Carpal Instability &amp; More Detail Of Carpal Instability: www.maitrise-orthop.com/corpusmaitri/ort...h/dumontier_us.shtml & www.maitrise-orthop.com/corpusmaitri/ort...3_saffar/index.shtml

Sadly there's no cure for Carpal Instability &amp; it's still sadly poorly misunderstood, so the treatments are limited &amp; very Controversial &amp; Experimental.

Most treatments would involve:

1. Physiotherapy/Exercise to the Fingers, Hands, Wrists, &amp; Upper-Limbs, &amp; Grip/Strengthening Exercises for your Hands/Wrists/Fingers &amp; this could go on for weeks/months/years.

2. Wrist Splints for use day &amp; night, Except for Baths/Showers &amp; Washing Up, &amp; twice a day plus Physiotherapy/Exercises. (You'd most probably be advised to wear the wrist splint for 6 - 8 weeks every day/night, Except for Baths/Showers &amp; Washing Up, &amp; twice a day plus Physiotherapy/Exercises) (Or you might have to wear the wrist spint for life or until an successful stabilizing wrist operation)

3. Hot &amp; Cold Therapy, Painkillers, Heat Pads, &amp; Counselling, all theses would be used to try to deal/cope with the Pain/Discomfort in your hands/wrists.

4. Just carry on with the above treatments &amp; hope you can live with the consent Pain/Discomfort &amp; Wrist Disability.

5. Look into the Controversial &amp; Experimental Wrist Operations for stabilizing/fusing the hands/wrists, in the hope of increasing grip/strength in your hands/wrists &amp; the hope to get rid of the Pain/Discomfort. (Sadly all Wrist Operations for Mid Carpal Instability, aren't cures &amp; there's no guarantee to improve Pain/Discomfort in the hands/wrists &amp; all operations will involve some decrease of mobility in your hands/wrists I.E. Bending/Flexing, but would hopefully improve strength/grip)<br><br>Post edited by: Scott_1984, at: 2008/01/27 17:30

wristinstability.multiply.com/journal/item/9

The first description of a “snapping wrist,” diagnosed as anterior midcarpal subluxation, was recorded in 1934, although “dorsal luxation of the capitate” had been presented in a congress in Paris in 1919.

However, it was Lichtman’s paper in 1981 that brought this particular condition to the attention of our profession.<br><br>Post edited by: Scott_1984, at: 2009/02/08 10:41

wristinstability.multiply.com/journal/item/14

Abstract: \&quot;This review addresses the pathoanatomical basics as well as the clinical and radiological presentation of instability patterns of the wrist.

Carpal instability mostly follows an injury; however, other diseases, like CPPD arthropathy, can be associated.

Instability occurs either if the carpus is unable to sustain physiologic loads (\&quot;dyskinetics\&quot;) or suffers from abnormal motion of its bones during movement (\&quot;dyskinematics\&quot;).

In the classification of carpal instability, dissociative subcategories (located within proximal carpal row) are differentiated from non-dissociative subcategories (present between the carpal rows) and combined patterns.

It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being \&quot;occult\&quot; for the radiologic assessment.

This paper emphasizes the high utility of kinematographic studies, contrast-enhanced magnetic resonance imaging (MRI) and MR arthrography for detecting these predynamic and dynamic instability stages.

Later in the natural history of carpal instability, static malalignment of the wrist and osteoarthritis will develop, both being associated with significant morbidity and disability.

To prevent individual and socio-economic implications, the handsurgeon or orthopedist, as well as the radiologist, is challenged for early and precise diagnosis.\&quot;<br><br>Post edited by: Scott_1984, at: 2009/02/08 10:40

A Slide Show Of Information, Surgeries, Therapiesa, &amp; More, On Carpal Instability: www.slideshare.net/hoc/carpal-instability