My wrist problems! TFCC and other stuff

[alisalemfb]

I have a medical issue, and  I would appreciate your thoughts about that. I moved to China 7 months ago for work, and start practicing Table Tennis intensively (2/3 hours a day) with a lot of smashing and looping. ( I do other sports include light weight lifting, I'm fit and healthy but my wrist seems to be a bit smaller comparing to my forearm ) I'm not sure if the pain was a result of table tennis or other activities. .. anyways, 6 months ago, My wrist developed a slight pain that gets a bit more intense  when I practice more than 30 minutes. I did not listen to my body warnings and kept playing, 4 months ago I saw a specialist ,while visiting japan, and he did X-ray and nothing in the X-ray to worry about so he suggested me to stop practicing for couple of weeks, which I did and in fact stopped and sport involves wrist motion for about a month, pain seems to be gone but when I went back to practicing the pain started to come back. I played for 2 months then I decided to stop playing till the pain is completely gone.

The pain is usually once I push the wall, or do push up, or try to stand up from a chair and use my hand to support or sometime when I try to open a bottle of milk etc. It does not hurts much usually but it annoys me. As I said, I'm currently in China for work, and saw a specialist and he suggested doing ultra sound thereby which I did and did not seem to help. I saw another specialist and he suggested doing acupuncture, which I had it 6 times until now, it did not seem to help either. I ask the the doctor to do MRI, and I just had it several days ago and the result was frightening, the MRI report was in Chinese language but my friend helped me to translate it into English, though she was not sure about some terminology, below the result:

1.Right wrist triangular fibrocartilage complex is injured.
2.Right wrist distal radius, navicular bone and lunar bone have bruise.
3.Right wrist Capitate bone tendon sheath is swollen.
4.There is bruise in the soft tissues of the right wrist radialis.


I would really appreciate your thoughts, how bad is my injury? and on average how long it would take to recover, I'm planing to avoid using the the wrist as I can to help it heal. will casting help? I just got a splint hoping it would help.

Thank you

[alisalemfb]

Thank you so much Dr. Mathur, that's really helpful.  I don't think I have DRU, though I'm not sure as I can't really understand the doctor as his English ability is very limited. what would be the symptoms of DRU?

Also, Will you recommend using glucosamine sulfate or/and piroxicam patch?

Thank you so much
Ali

[Dr. Kokil Mathur]

Hi!
It all depends on whether you have distal radio-ulna joint instability (DRU). An injured TFCC and other ligaments without DRU can be managed by rest and anti-inflammatory and/or pain medications. The wrist can be stabilized by wrist supports, splints, casts or by surgery.  If this is not treated in time, it can worsen the pain and de-stabilize the wrist.  If there is DRU, then this is treated by reconstructing TFCC with partial extensor carpi ulnaris (ECU) tendon along with/without ulnar shortening. Bone bruise will heal with conservative treatment. It is a god idea to use the wrist minimally. Please consult an orthopedic specialist in a reputed hospital. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.