Case Study Reveals 'Percussionist Wrist' Injury

Similar to tennis elbow, painless growth appears to be instance of overuse

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WEDNESDAY, Sept. 1, 2010 (HealthDay News) -- Percussionists may be at risk for wrist overuse injuries, a case study suggests.

The case involved a 70-year-old man with a growing, but painless, mass on his left wrist, according to rheumatologists at the University of Pennsylvania in Philadelphia. A similar growth on the man's right wrist had cleared up without treatment. The patient had no obvious recent injuries to his wrists or hands, but he had been a professional percussionist for more than 30 years.

Both of the man's hands were stiff and he had limited movement of the wrists. Fluid drained from the mass on his left wrist showed no signs of infection, but X-rays revealed a wrist deformity called scapholunate advanced collapse (SLAC) -- a collapse of certain bones in the wrist joint.

SLAC is a common form of arthritis that can be caused by such things as trauma and manual labor. Surgery to correct the wrist deformity may be required in cases where SLAC causes pain, but this patient did not need surgery.

The researchers, Dr. Naoto Yokogawa and Dr. H. Ralph Schumacher Jr., also said an MRI scan showed that the mass on the man's left wrist was caused by tenosynovitis -- inflammation of the tissues that surround the wrist tendons. This is a common problem in percussionists.

This unusual case of "percussionist's wrist" appeared to be an overuse injury similar to elbow tendonitis or knee problems that can develop in runners. In this case, repeated "microtrauma" caused damage to the wrist ligaments over time, eventually leading to the SLAC wrist deformity, according to the doctors.

The report is published in the August issue of JCR: Journal of Clinical Rheumatology.

More information

The American Academy of Orthopaedic Surgeons has more about arthritis of the wrist.

SOURCE: JCR: Journal of Clinical Rheumatology, news release, August 2010


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