Diagnostic Approaach

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.