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The presentation, diagnosis and management of non-traumatic wrist pain: an evaluation of current practice in secondary care in the UK NHS

Dean, Benjamin J.F.; Carr, Andrew; Trickett, Ryan W.; Kluzek, Stefan; Riley, Nicholas; Bretherton, Christopher P.; Wilson, Melanie K.; Hayton, Mike J.; Rupani, Neal R.; Hsieh, Daniel; Cheng, Ching

The presentation, diagnosis and management of non-traumatic wrist pain: an evaluation of current practice in secondary care in the UK NHS Thumbnail


Authors

Benjamin J.F. Dean

Andrew Carr

Ryan W. Trickett

Profile image of STEFAN KLUZEK

STEFAN KLUZEK Stefan.Kluzek@nottingham.ac.uk
Clinical Associate Professor

Nicholas Riley

Christopher P. Bretherton

Melanie K. Wilson

Mike J. Hayton

Neal R. Rupani

Daniel Hsieh

Ching Cheng



Abstract

Objectives. The study aims were to assess the burden of non-traumatic wrist pain in terms of numbers of referrals to secondary care and to characterize how patients present, are diagnosed and are managed in secondary care in the UK National Health Service. Methods. Ten consecutive patients presenting with non-traumatic wrist pain were identified retrospectively at each of 16 participating hospitals, and data were extracted for 12 months after the initial referral. Results. The 160 patients consisted of 100 females and 60 males with a median age of 49 years, accounting for ∼13% of all new hand/wrist referrals. The dominant wrist was affected in 60% of cases, and the mean symptom duration was 13.3 months. Diagnoses were grouped as follows: OA (31%), tendinopathy (13%), ganglion (14%), ulnar sided pain (17%) and other (25%). The OA group was significantly older than other groups, and other groups contained a predominance of females. The nonsurgical interventions, in decreasing frequency of usage, were as follows: CS injections (39%), physiotherapy (32%), splint (31%) and analgesics (12%). Of those who underwent surgery, all patients had previously received non-surgical treatment, but 42% had undergone only one non-surgical intervention. Conclusions. Non-traumatic wrist pain represents a significant burden to secondary care both in terms of new patient referrals and in terms of investigation, follow-up and treatment. Those presenting with OA are more likely to be older and male, whereas those presenting with other diagnoses are more likely to be younger and female.

Citation

Dean, B. J., Carr, A., Trickett, R. W., Kluzek, S., Riley, N., Bretherton, C. P., …Cheng, C. (2020). The presentation, diagnosis and management of non-traumatic wrist pain: an evaluation of current practice in secondary care in the UK NHS. Rheumatology Advances in Practice, 4(2), Article rkaa030. https://doi.org/10.1093/rap/rkaa030

Journal Article Type Article
Acceptance Date Jun 11, 2020
Online Publication Date Jul 7, 2020
Publication Date Jul 7, 2020
Deposit Date Aug 18, 2020
Publicly Available Date Aug 21, 2020
Journal Rheumatology Advances in Practice
Electronic ISSN 2514-1775
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 4
Issue 2
Article Number rkaa030
DOI https://doi.org/10.1093/rap/rkaa030
Keywords wrist, pain, osteoarthiritis, surgery, National Health Service
Public URL https://nottingham-repository.worktribe.com/output/4781163
Publisher URL https://academic.oup.com/rheumap/advance-article/doi/10.1093/rap/rkaa030/5868418
Additional Information The MOWP study group.

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