Version June 2024
| Condition | Location | Clinical features | Radiographic findings | Associated activities |
| Simple sprain | Dorsal | Mild pain or stiffness at full wrist flexion or extension or both, normal range of motion; resolves in two weeks | Wrist series is normal | |
| Distal radius fracture | Radial | Common during adolescent growth spurt; point tenderness, swelling, ecchymosis, decreased grip strength | Fracture on standard wrist series | Impact sports; fall on extended wrist |
| Scapholunate instability | Radial | Swelling, focal pain and tenderness, decreased range of motion, decreased grip strength, positive scaphoid stability test (but may not be able to tolerate) | Increased scapholunate distance on AP view; increased scapholunate angle on lateral view; but may be normal | Impact sports; racquet, stick, and club sports; fall on extended wrist |
| Scaphoid (navicular) fracture | Radial, dorsal | Tenderness in anatomic snuffbox; decreased range of motion in flexion and extension; positive scaphoid compression test | Fracture may be seen on AP view with ulnar deviation; may need scaphoid series. Initial radiographs may not demonstrate fracture. When suspected, thumb spica splinting and repeat radiographs in 7 to 10 days should be performed. Bone scan or MRI can demonstrate fracture sooner when earlier diagnosis is necessary (eg, elite athletes). | Impact sports, particularly football; fall on extended wrist |
| Midcarpal instability | Ulnar | Sulcus in the dorsal ulnar wrist border; painful clunk with active ulnar deviation | Dislocaton on standard wrist series | |
| Distal ulnar fracture | Ulnar, dorsal | Usually occurs with distal radius fracture; associated with TFCC injury | Fracture on standard wrist series | Impact sports |
| Triquetral fracture | Ulnar, dorsal | Point tenderness over the triquetrum or on the ulnar border, distal to the ulnar styloid | Fracture on standard wrist series | Impact sports |
| Lunotriquetral ligament instability | Ulnar, dorsal | Tenderness of the lunotriquetral ligament in the ulnar snuff box; positive lunotriquetral shear test | Usually normal; may be step-off along proximal carpal row; associated with positive ulnar variance | Impact sports |
| Triangular fibrocartilage complex (TFCC) tears | Ulnar, dorsal | Point tenderness over the lateral wrist just distal to the ulnar styloid; pain with forced ulnar deviation or TFCC compression test | Associated (but not diagnostic) findings: widening of DRUJ space, positive ulnar variance, fracture of ulnar styloid on AP; dislocation or subluxation on lateral. MRI with intra-articular contrast is most sensitive means of identifying TFCC injury | Impact sports; racquet, stick, and club sports; gymnastics |
| Distal radioulnar joint (DRUJ) injury | Ulnar, dorsal | Pain with supination and pronation; positive DRUJ compression or piano key tests | Dislocation can be seen on plain radiographs and these should include AP and lateral views of the forearm to assess for an associated radial fracture (Galeazzi fracture); MRI may be necessary to identify instability | Impact sports; racquet, stick, and club sports; gymnastics |
| Hamate hook fracture | Ulnar, palmar | Pain with sports but not daily activities; point tenderness over the hook of the hamate | Fracture best seen on 45° supination oblique or carpal tunnel view or with CT | Racquet, stick, and club sports |
| Pisiform fracture | Ulnar, palmar | Pain with palpation of the pisiform and hypothenar eminence | Fracture on standard wrist series |
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