WRIST IMPINGEMENT
There have been various terminologies applied to a varied group of syndromes that cause pain by soft tissue or bony impingement
Some are referred to as abutments, some impactions and some impingements
The term impingement has come more generally into common usage, largely because of increased awareness of impingements elsewhere, particularily the ankle
The abutment syndromes are covered in their own section
Other will be dealt with here
RADIOULNAR IMPACTION
Ulnar impaction syndrome is a different entiity.
This generally arises as a result of arthropathy of the distal radioulnar joint where the articular surface of the ulna impinges against the radius.
It can be mimiced by congenital abnormalities such as
Negative ulnar variance and Madelungs deformity
HAMATOLUNATE IMPINGEMENT
Hamatolunate impingement can occur when there is a second articular surface of the distal lunate articulating with the hamate .
This is called a type 2 lunate
Many type 2 lunates are asymptomatic but their presence predisposes to HL impingement
Pain occurs on axial compression and ulnar deviation
Look for chondromalacia, subchondral oedema and eventually subchondral cyst formation
DORSAL IMPINGEMENT
Symptoms of dorsal ganglion can be mimiced by injuries to the scapholunate ligament and
Posterior impingement or capsulitis
HYPOTHENAR HAMMER SYNDROME
Digital ischaemia as a result of acute or repetitive compression of the hypothenar eminence.
The ulnar artery and terminal branches of the ulnar nerve was susceptible to compression against the hook of the hamate
Thrombosis of the ulnar artery occur is leading to digital ischemia
The superficial branch of the ulnar artery is more susceptible than the deep branch
Occasionally aneurysmal dilatatione can occur
Symptoms tend to be worse in smokers