Hand Ball, More Than Just A Penalty? - Page #1

Author: Richard Chen, MD
Co Author #1: Jason Krystofiak MD
Co Author #2: Jason Womack MD
Senior Editor: Joseph Chorley, MD
Editor: Natalie Stork, MD

Patient Presentation:
A 25 year-old, right hand dominant, National Women's Soccer League forward presented with acute onset of left wrist pain and swelling.

The athlete's left wrist was struck on the dorsal aspect of the wrist by the ball during game-play. She was able to finish the game without difficulty. After the game, she noticed a sharp pain, as well as swelling, in her left wrist over the dorsal and radial aspect. Pain was worse with wrist extension and radial deviation.

She denied prior wrist injuries or surgeries. She denied numbness, tingling, weakness, clicking, instability or deformity.

Physical Exam:
Left wrist:
Inspection: dorsal swelling without deformity
Palpation: tender to palpation over the mid-dorsal wrist and the radial styloid
Range of motion: full range-of-motion in all planes; pain reproduced with extension and radial deviation
Strength: 5/5 wrist flexion, extension, radial and ulnar deviation, pain with resisted extension and radial deviation; 5/5 forearm pronation and supination
Sensation: grossly intact in all left upper extremity dermatomes
Vascular: 2+ radial pulses; no cyanosis
Reflexes: 2+ brachioradialis
Special tests: (+)grind test, (+)shuck test

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Phone: 913.327.1415

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