Arthroscopic Management of Dorsal Wrist Syndrome
Dorsal wrist capsular impingement (DWCI) is defined as pain at the dorsal radiocarpal joint attributed to impingement of dorsal wrist capsular tissue during wrist extension, or dorsal wrist syndrome (DWS) if etiology is unclear. It is thought that microtrauma and chronic injury are caused by avulsion of the extrinsic ligaments of the wrist, which over time causes impingement between the extensor carpi radialis brevis and scaphoid. Patients often present with complaints of pain during extreme extension, especially when loaded. Pain with active or passive terminal extension is key to diagnosis, and further imaging such as MRI may be obtained when diagnosis is unclear. However, a negative MRI does not rule out DWCI diagnosis. Treatment includes diagnostic arthroscopy for confirmation of diagnosis and dorsal capsular debridement. Patients experience improvement in pain and functional scores with limited improvement in range of motion.
