Wrist pain assessment and arthritis management in GP

In this episode of The Good GP Podcast, host Dr Tim Koh is joined by Dr Jeff Ecker, an experienced orthopaedic surgeon based in Perth, to discuss the complexities of assessing and managing wrist conditions in general practice.

Dr Ecker outlines the importance of a thorough history and clinical assessment in patients presenting with wrist pain, emphasising that pain may originate from structures beyond the wrist itself, such as the distal radioulnar joint or even referred from the neck. He highlights common causes of wrist pain that GPs are likely to encounter, including arthritis, ligament injuries, and overuse conditions, and discusses the challenges associated with diagnosis.

Focusing on wrist arthritis, as a common cause of pain in older patients. He described key clinical features and examination findings, alongside considerations for distinguishing arthritis from other conditions. The approach to imaging, including the use of CT scanning to detect bony changes and calcium pyrophosphate deposition, is covered. He also outlined management options, from conservative measures, through to surgical intervention. 

Dr Ecker stresses the importance of patient-centred decision making, informed consent, and multidisciplinary collaboration between surgeons, therapists, and GPs. Surgical options including arthroscopy, joint replacement, and wrist fusion are explained, with considerations for patient selection and postoperative rehabilitation.

They conclude with practical advice for GPs supporting patients to maintain function and quality of life, emphasising resilience, adaptation, and the value of ongoing measurement and rehabilitation.

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