Diagnosis

During the physical exam, your doctor may:

• Check your wrist for tenderness, swelling or deformity
• Ask you to move your wrist to check for a decrease in your range of motion
• Assess your grip strength and forearm strength

In some cases, your doctor may suggest imaging tests, arthroscopy or nerve tests.

Imaging tests

• X-rays. This is the most commonly used test for wrist pain. Using a small amount of radiation, X-rays can reveal bone fractures or signs of osteoarthritis.
• CT. This scan can provide more-detailed views of the bones in your wrist and may spot fractures that don't show up on X-rays.
• MRI. This test uses radio waves and a strong magnetic field to produce detailed images of your bones and soft tissues. For a wrist MRI, you may be able to insert your arm into a smaller device instead of a whole-body MRI machine.
• Ultrasound. This simple, noninvasive test can help visualize tendons, ligaments and cysts.

Arthroscopy

If imaging test results are inconclusive, your doctor may perform an arthroscopy, a procedure in which a pencil-sized instrument called an arthroscope is inserted into your wrist through a small incision in your skin. The instrument contains a light and a tiny camera, which projects images onto a television monitor. Arthroscopy is considered the gold standard for evaluating long-term wrist pain. In some cases, your doctor may repair wrist problems through the arthroscope.

Nerve tests

Your doctor might order an electromyogram (EMG) if carpal tunnel syndrome is suspected. This test measures the tiny electrical discharges produced in your muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when the muscle is at rest and when it's contracted. Nerve conduction studies also are performed as part of an EMG to assess if the electrical impulses are slowed in the region of the carpal tunnel.