When A Mis-hit Eclipses A Season: Wrist Pain In A Collegiate Tennis Player - Page #1

Author: Katherine Herold, MD
Co Author #1: Jonathan A. Becker, M.D.
Editor: Daniel Parker, MD

Patient Presentation:
A 20 year-old Division 1 left-handed collegiate tennis player with acute onset left dorsal wrist pain during a tournament.

He hit an overhead on the side of his racquet, which twisted his left wrist and forced it into hyperextension. Despite constant pain, he completed the tournament. He localized the pain to the dorsal aspect of his left wrist, and noted that hyperextension induced radial pain. There was no associated numbness, tingling, or weakness. No prior history of pain, innjury, or trauma to either upper extremity. He had no recent change in his grip style or training regimine.

Physical Exam:
Left forearm, wrist, and hand without swelling or deformity.
Diffuse tenderness was elicited over the radial aspect of the left wrist and was exacerbated by extension.
No point tenderness was present at the radial styloid.
He had full range of motion and full strength of his wrist, hand, and digits.
Fincklestein's test was negative.
The hand and wrist were neurovascularly intact, including deep tendon reflexes.
Completely normal examination of his contralateral wrist.

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