Abstract
Background The etiology of dorsal wrist pain associated with loading of the wrist in extension
has not been clearly identified in the literature.
Purpose Many exercise disciplines incorporate upper extremity weight-bearing exercises in
an extended wrist posture, for example push-ups, plank position, and various yoga
and Pilates poses. This study evaluates patients with dorsal wrist pain in the extended
wrist-loading position and identifies anatomic abnormalities in the wrist using magnetic
resonance imaging (MRI).
Methods A retrospective chart review was performed comparing MRI of patients who complained
of dorsal wrist pain while performing weight bearing in a wrist extension position
with a control group of patients who complained of ulnar-sided wrist pain. The primary
MRI outcome was dorsal wrist pathology, including occult dorsal ganglion cyst, scapholunate
ligament tear or degeneration, and dorsal capsulitis.
Results Dorsal wrist pathology was significantly more prevalent in patients with dorsal wrist
pain (84%) than in the patient cohort with ulnar-sided wrist pain (12%). Occult dorsal
ganglion cysts were the most common sources of pathology (76%).
Conclusion MRI demonstrated an identifiable dorsal abnormality in 84% of patients with dorsal
wrist pain associated with weight bearing on the extended wrist. Occult dorsal ganglion
cysts are the most common cause of dorsal wrist pain, followed by partial scapholunate
tears. When patients complain of dorsal wrist pain during specific extended loading
wrist positions such as push-ups, yoga, or Pilates poses, an MRI may be warranted
to help identify anatomic abnormalities that may help guide treatment choices.
Level of Evidence Diagnostic, Level III.
Keywords
dorsal wrist pain - wrist loading - dorsal ganglion - imaging
