Wrist Assessment
Physiotherapy · Subjective & Objective Examination
WRIST / HAND
RightLeft
RightLeftBilat
1
Presentation & Red Flags
Red flags — screen & tick
Consider urgent / further review if any of:
No red flagsFractureOedemaColorationFunctional impotenceHigh-velocity fallCRPS / SDRC symptoms
2
History
3
Pain
Mark pain location, type & radiation
No pain
Worst
0
1
2
3
4
5
6
7
8
9
10
Morning
Afternoon
Evening
Night
Plot key events along the line — injury, flare-ups, treatments, return to activity, milestones.
4
Lifestyle & Context
Sleep
Diet
Smoking
Alcohol
5
Clinical Reasoning Framework
Characterise the presentation — circle / annotate the relevant descriptors on each strip.
Diagnosis
Stage of disorder
Pain features
6
Flags & Whole-Person Considerations
7
Goals
8
Objective — Wrist
Observation
Observation
| Swelling | Coloration | Deformity | Muscle atrophy | Finger position | Thumb position |
|---|---|---|---|---|---|
Range of movement + pain active — record response and pain for each
| Movement | Right | Left | Pain / Notes |
|---|---|---|---|
| Flexion | |||
| Extension | |||
| Radial deviation | |||
| Ulnar deviation | |||
| Pronation | |||
| Supination | |||
| Fingers — flexion / extension each finger | |||
| Fingers — abduction / adduction each finger |
Passive mobility
| Movement | Right | Left | Finding / Notes |
|---|---|---|---|
| Flexion | |||
| Extension | |||
| Radial deviation | |||
| Ulnar deviation | |||
| Pronation | |||
| Supination | |||
| Carpometacarpal mobilisation | |||
| Metacarpophalangeal mobilisation | |||
| Interphalangeal mobilisation |
Special tests
| Structure | Special test | Right | Left | Finding / Notes |
|---|---|---|---|---|
| Scaphoid | Palpation of scaphoid | |||
| Scaphoid | Anatomical snuffbox tenderness | |||
| Scapho-lunate | Scapho-lunate palpation | |||
| Scapho-lunate | Scapho-lunate ballottement | |||
| Scapho-lunate | Watson test | |||
| TFCC | DRUJ stability | |||
| TFCC | Ulnar-sided wrist compression | |||
| TFCC | Extension + pronation / supination | |||
| TFCC | Lift-off test | |||
| Thumb MCP / UCL | Radial deviation testing | |||
| Thumb MCP / UCL | Bilateral comparison | |||
| Carpal tunnel | Phalen test | |||
| Carpal tunnel | Tinel test | |||
| De Quervain | WHAT test | |||
| De Quervain | Eichhoff test | |||
| Trigger finger | Flexion / extension of the finger | |||
| Trigger finger | Pain / catching / triggering |
Strength
| Measure | Right | Left | Notes |
|---|---|---|---|
| Grip strength bilateral comparison |
Palpation tick tender / relevant structures
1st carpal row
ScaphoidLunateTriquetrumPisiform
2nd carpal row
TrapeziumTrapezoidCapitateHamate
Hand
MetacarpalsPhalangesSoft tissues
Neurological examination
| Item | Right | Left | Finding / Notes |
|---|---|---|---|
| Sensitivity | |||
| Median nerve | |||
| Paresthesia | |||
| Grip strength | |||
| Thenar muscle atrophy |
If neuropathic symptoms: NPSI · DN4 (see Questionnaires).
9
Functional Assessment
Functional assessment
| Task | Right | Left | Observation / Notes |
|---|---|---|---|
| Grip | |||
| Push | |||
| Pull | |||
| Weight-bearing | |||
| Lift | |||
| Twist | |||
| Finger flexion / extension | |||
| Thumb grip | |||
| Thumb opposition | |||
| Others |
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Adjacent Joints
Elbow
ROM · Flexion · Extension · Pronation · Supination
Cervical
ROM · Neurodynamic tests if indicated
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Others
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Retest
| Date | Test / measure | Result | Notes |
|---|---|---|---|
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Questionnaires
Patient-reported outcome measures — record the score at baseline and at each retest.
| Questionnaire | Date | Score | Notes / interpretation |
|---|---|---|---|
| Patient-Rated Wrist Evaluation (PRWE) | |||
| QuickDASH | |||
| DN4 — neuropathic pain | |||
| Dreiser Index osteoarthritis | |||
| NPSI neuropathic pain | |||
| QDSA pain management difficulties |
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