I have no pain at this point. I had therapy for 4 weeks and its been a month since then. In therapy my wrist was stiff and slightly painful but that was probably to do with being in a splint for 2 months. I quickly regained strength and lost the pain and stiffness. Basically my hand surgeon was either too cautious or a dishonest. There is no doubt in my mind that funds flow both ways between the doctor's office and the PT. And he is a world famous surgeon! It's obvious my ligament was never torn and I have a ganglion cyst. I got a second opinion from another less famous but equally competent hand surgeon, and was told that the MRI was of a very high quality and the x-ray was of a very poor quality. The MRI clearly shows a ganglion cyst while the x-ray shows nothing in particular. This incident has only increased my distrust in the medical system and doctors watching out for either their own pockets or stroking their egos.
I am thinking that maybe it could be a ligament tear since often it is hard to tell from an X-ray, especially if the injury has just occurred. But I am assuming that this was why they had you do an MRI, but you must remember that these aren't always accurate either. I was told about 3 weeks ago that I just had a ganglion cyst develop after an unfortunate fall and not to worry about anything, but today I went to an orthopedic surgeon since the pain was definitely still there and he informed me that I actually have an SL tear which will require surgery. It was evident from my X-ray that there was a gap between two of my bones, but I was told that it takes time for the gap to develop and become visible so maybe if your pain is persistent and does not go away, you could ask for them to do a follow up x-ray some time from now and see if there is still no sign of a ligament tear. Not knowing what is wrong is definitely a terrible feeling!! :(
Thank you for your reply. I have been in physical therapy for about a week now and I am gaining back a good bit of range of motion, strength, etc. However I still have what I would best describe as a dull aching pain in my wrist. I had another doctor look at my MRI, and he said it was surely an occult dorsal ganglion cyst that was cause of my pain and that my SL ligament seems fine. Will physical therapy actually help me or hurt me? If I am feeling pain at this stage (2 months of being in a splint, followed by therapy) is it more likely I have a ganglion cyst or a ligament tear?
Hi there!
Well, this would be a difficult situation to comment on, without knowing the relevant clinical details or having had a look at the imaging studies. However, there should be no harm done in trying to treat this as a scapho-lunate ligament tear, since the approach is conservative. The stiffness is likely to be a result of splintage and should improve overtime with appropriate physiotherapy.
Hope this is helpful.
Take care!