A Clinical Approach to Diagnosing Trigger Wrist

Trigger Wrist Caused by a Rheumatoid Nodule on the Flexor Pollicis Longus Tendon

“…9 Arumugam et al described evaluating for an absence of tenderness over the A1 pulley in patients with trigger finger to suggest possible trigger wrist. 14 As case reports of trigger wrist have been published, attempts have been made to create a classification system. In 1985, Suematsu et al reported on three types of triggering of the wrist: (1) type A, a mass occurring on the flexor tendon or flexor tendon sheath as it enters and leaves the carpal tunnel; (2) type B, an anomalous muscle belly entering and leaving the carpal tunnel (including an abnormal lumbrical muscle or abnormal muscle belly of the flexor digitorum superficialis); and (3) type C, a combination of tumor and anomalous muscle.…”

Snapping of the Upper Limb: a Clinical Overview

“…Snapping wrist is a relatively rare condition with few reported cases in the literature. The terms "snapping wrist" and "trigger wrist" are interchangeably used to define a pathology presenting with painful sensation and a clicking sound during finger and wrist movements (2,6). The definition of trigger wrist remains controversial.…”

“…However, in 1986, Desai et al (67) proposed to use the term trigger wrist to indicate triggering which occurs following the movement of the wrist and not that of the fingers (68). This is true trigger wrist while the condition in which triggering at the wrist is associated with finger movements would be more appropriately described as trigger finger at the wrist (6). Recently, it has been proposed that both true trigger wrist and the trigger finger at the wrist are combined under the unifying denomination of trigger wrist (6).…”

“…When it is associated with severe pain and functional impairments, leading to significant reduction in sports and professional activities, surgical management may be necessary (4)(5)(6). Snapping phenomena have been reported in various regions of the body, especially in close proximity to joints characterized by a wide range of motion, which allows an anatomical or heterotypic structure to interact with its surrounding environment (1,5,6). Snapping phenomena may affect bony structures resulting in the so-called "joint instability".…”

“…When intra-articular, snapping of the elbow may be related to the synovial fringe capsule-synovial layer at the junction between the radial collateral ligament and the annular ligament (4). Snapping sensation in the wrist has been traditionally thought to be due to underlying carpal instability or tendon instability such as snapping of the extensor carpi ulnaris secondary to a subsheath tear (2,6). Identifying the structures responsible for the snap and their underlying pathology could be clinically challenging considering that different sites and multiple causes may contribute to the snapping phenomenon.…”