Ulnar sided wrist pain

3 months ago I hurt my wrist while using cutting shears to trim my trees.  Woke up the next day with pain, initially though it was a sprain so I waited a month to go see the doctor.  I could not put my hand palm up without a lot of pain.  I was placed in a splint and physical therapy for 4 weeks.  The PT also did a cortisone patch 4 times during pt to alleviate swelling.  I was also put on an oral steroid.  Both had short term relief.  4 weeks later back to doctor and told to have a cortisone shot,  felt relief for 2 weeks.  4 weeks after that back to doctor.  He wanted to do oral steriods and another shot but I said no.  So he is sending me for an MRI without contrast.  He said it was a tfcc tear at my initial appointment and now he believes it might be my pisotriquetral joint.  All this time i also have swelling on the side of my wrist. My question is why isn't the MRI done sooner instead of playing a guessing game for 3 months?  I am getting a 2nd opinion because I am uncomfortable with how many times he thinks oral steroids would help if they didn't help the first time.  Ay thoughts?

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation it would be difficult to comment specifically on the situation; though I would agree that an MRI should have been done earlier since the symptoms had not improved over 1 month. Also repeated steroid shots are not recommended unless a specific diagnosis is made and the risks outweigh the benefits. Other possibilities that may need to be considered include fractures, dislocations, injuries to tendons/ muscles/ ligaments etc. I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management.
Hope this is helpful.

Take care!