II. Epidemiology

  1. Very common sports overuse syndrome

III. Mechanism

  1. Related to racquet sports with repetitive wrist motion
    1. Squash
    2. Badminton
    3. Racquetball
    4. Rowing
    5. Tennis
  2. Tennis player with two handed backhand
    1. Excessive ulnar deviation in nondominant wrist

IV. Symptoms

  1. Ulnar Wrist Pain in racquet sport athlete

V. Signs

  1. Extensor Carpi Ulnaris (ECU) location
    1. Supination: Dorsal to ulnar styloid
    2. Pronation: Volar to ulnar styloid
  2. Tenderness over ECU in sixth dorsal compartment
  3. Severe pain on resisted supination

VI. Differential Diagnosis

  1. Subluxation of ECU (Traumatic rupture of subsheath)
  2. Thumb Ulnar Collateral Ligament Injury
  3. Anterior Cubital Tendon Injury
  4. Pisiform-Triquetrum Joint Injury
  5. Triquetrum-Lunate Joint Injury
  6. Triangular Fibrocartilage Complex Injury

VII. Management

  1. General
    1. Rest
    2. Splinting
    3. NSAIDs
  2. Acute
    1. Consider local Corticosteroid Injection
  3. Chronic
    1. Consider surgical decompression

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