Long-term outcome of nonsurgically treated patients with wrist pain and a normal arthrogram.

Abstract

A series of 52 patients who had been treated nonsurgically for wrist pain after an inconclusive physical examination, normal standard radiographs, and a negative radiocarpal arthrogram result were surveyed using the Disabilities of the Arm, Shoulder, and Hand (DASH) and Short Form-12 (SF-12) instruments after a minimum of 2 years (average, 6.1 years). Forty-two patients (81%) responded to the survey. Average duration of symptoms before the initial evaluation was 13 months. At follow-up evaluation, mean SF-12 score was 50 (national mean, 50). Mean DASH score was 17 compared with 2 for a control group of 60 people. Sixty-four percent of patients reported improvement, 19% were unchanged, and 17% were worse since the initial evaluation. Two patients were receiving disability benefits. Duration of symptoms >12 months was associated with a worse outcome. These results show that patients with wrist pain but without a diagnosis by these evaluation methods often have persistent symptoms after nonsurgical treatment, but the symptoms are usually mild and improve.