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Wrist injuries part 1: pinpointing pathology in a complex joint.

The wrist is a complex joint and a common site for injury in virtually every type of recreational activity. This article describes a workup that will lay the groundwork for a diagnosis more specific than wrist sprain or strain. Instructions are given for taking a detailed history, palpating the five zones of the wrist, performing provocative maneuvers, giving diagnostic injections, and obtaining imaging studies. Plain x-rays of both wrists may be sufficient to diagnose a fracture or subluxation, but if x-rays are negative and a fracture is still suspected, other imaging studies may be needed. Diagnosis and management of wrist injuries will be described in part 2.