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Gymnast wrist

Case contributed by Neguib Rosado Buenfil
Diagnosis almost certain

Presentation

Gymnast with pain in the left wrist for the last two weeks.

Patient Data

Age: 11 years
Gender: Female
x-ray

Mild widening of the radial physeal plate with irregularity/ill-defined borders on the metaphyseal side.

Case Discussion

Gymnast wrist is an overuse injury of the distal radial physis, resulting from repetitive axial loading on the wrist (pronation and extension).

There is typically a history of gymnastics or weight-lifting training.

Physical examination will show tenderness along the distal radial physis and pain with hyperextension and axial loading.

Plain film findings:

  • widening of radial growth plate
  • irregularity/ill-defined borders (most common on metaphyseal side)
  • positive ulnar variance
  • cystic changes/sclerosis

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