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Abstract
Objective To provide a clinical overview of selected common pathologies causing radial-sided wrist pain and to guide primary care physicians in the diagnostic approach and initial management of these conditions.
Sources of information A literature review was conducted using the PubMed MEDLINE database, supplemented by reference musculoskeletal clinical textbooks.
Main message Radial-sided wrist pain has a wide differential diagnosis due to the complex anatomy of the wrist. A thorough clinical evaluation—including detailed history, physical examination, and appropriate imaging—is essential for accurate diagnosis. Several common conditions are presented with diagnostic features, relevant physical examination tests, and an overview of treatment options.
Conclusion Radial-sided wrist pain requires careful clinical assessment to differentiate among multiple pathologies originating from anatomic causes. Primary care physicians can effectively manage many of these conditions with appropriate diagnostic strategies and conservative treatments. Early recognition and targeted interventions can prevent complications and improve patient outcomes.
Musculoskeletal concerns account for about one-fifth to one-quarter of all primary care visits.1,2 Among those, hand and wrist concerns account for 47 to 60 cases per 1000 patients per year.3 Given the large number of anatomic structures in the relatively small volume of the wrist, radial-sided wrist pain can present a diagnostic challenge. We provide a clinical review of selected common hand and wrist pathologies affecting the radial side of the wrist, defined as the region from the distal radius to the mid-first volar and dorsal metacarpal to a line between the radius and ulna to the base of the second metacarpal.
Acute abdominal pain is one of the most common symptoms in patients presenting to the emergency department and accounts for 5 to 10% of all emergency department visits. Pathophysiological conditions that lead to surgical interventions in such patients are mainly gastrointestinal obstruction, hemorrhage, ischemia, and viscus perforation. Acute abdominal pain can be diffuse or localized (i.e., quadrant-based epigastric pain or pain in the right upper quadrant, left upper quadrant, right lower quadrant, or left lower quadrant)2,4,6 and is associated with but not limited to the following disease processes: perforated viscus, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and intraabdominal hemorrhage. The need for emergency general surgery is an independent risk factor for postoperative complications and death, indicating the severity of the condition. Therefore, timely diagnosis of acute abdominal emergencies is essential. From antiquity to modern times, medical students have been taught that the history and the physical examination are the central components in the evaluation of acute abdominal pain.
Skin lesions of the face, trunk, and extremities are commonly seen in the pediatric population. Although most of these lesions are benign, they can be locally destructive or interfere with normal development. Recognition and diagnosis of these lesions allow for timely workup and referral; treatment, if needed; and facilitation of parental discussions. The purpose of this article is to review common pediatric skin and soft-tissue lesions-or "lumps, bumps, and birthmarks"-to assist with diagnosis, workup, and guidelines for referral to pediatric plastic surgery. [Pediatr Ann. 2023;52(1):e23-e30.].
One challenge in the treatment of plantar fasciitis is that very few high-quality studies exist comparing different treatment modalities to guide evidence-based management. Current literature suggests a change to the way that plantar fasciitis is managed. This article reviews the most current literature on plantar fasciitis and showcases recommended treatment guidelines. This serves to assist physicians in diagnosing and treating heel pain with plantar fasciitis.