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Nonspecific Wrist Pain in Adolescent Females
Srinithya R Gillipelli, BA
1,2, Winston R Owens, BS
2, Vamsi Mohan, MD
3, Heather R. Burns, MD
2; William C. Pederson, MD
2,3(1)Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, (2)Baylor College of Medicine, Houston, TX, (3)Texas Children's Hospital, Houston, TX
BACKGROUND: Nonspecific wrist pain frequently affects adolescent females. Despite thorough evaluation, a diagnosis and management plan are often unable to be made. There is a paucity of literature regarding management of nonspecific wrist pain. The aim of our study was to determine the management and outcomes of nonspecific wrist pain in adolescent females who presented at a large academic pediatric hospital.
METHODS: A retrospective analysis was conducted on females who presented at ages 12-18 years from 2012-2024 with nonspecific wrist pain and negative initial x-ray.
RESULTS: The cohort included 125 patients with a median age of 13 [interquartile range: 12-13] years; 57% reported previous wrist injuries. Sixty percent of patients required additional imaging, with MRI being the most common. The majority of cases were inconclusive (30%), followed by instability (20%), structural abnormalities (18%), mass (16%), and inflammatory conditions (15%). Of inconclusive cases, splinting (47.3%) was the most common treatment and those whose pain improved were treated for 4.7 [2.8-8.6] weeks in splinting or 5 [3-7.2] weeks in casting. Time to pain improvement was observed to be the quickest in inconclusive cases (4.7 [2.6-7.9] weeks). Overall improvement in pain in inconclusive cases (65.8%) was lower than inflammatory (94.7%) and structural cases (82.6%). Patients with known wrist injuries had quicker improvement in pain versus those without (6.6 vs. 9 weeks, p=0.03).
CONCLUSION: Conservative management, specifically splinting and casting, and can be utilized to effectively treat nonspecific wrist pain in adolescent females. Early secondary imaging can reveal disease pathology, informing targeted treatment.
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