SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Osteoarthritis of wrist
Other Resources UpToDate PubMed

Osteoarthritis of wrist

Contributors: Sean Pickard BS, Derek T. Schloemann MD, MPHS, Danielle Wilbur MD
Other Resources UpToDate PubMed


Causes / typical injury mechanism: Osteoarthritis (OA) can be classified as primary or secondary. In primary OA, there is no preceding trauma, and the pathogenesis is often multifactorial. Risk factors for primary OA often include genetics, joint morphology, and possibly underlying endocrine abnormalities. Risk factors for secondary OA include fracture, dislocation, and infection.

In wrist OA, primary OA is caused by avascular necrosis or congenital deformities and commonly involves the scaphotrapeziotrapezoid (STT) joint. Secondary OA is generally brought about by trauma, particularly scapholunate ligament injury, distal radius fracture, and scaphoid fracture. The majority of cases of wrist arthritis are a result of scapholunate advanced collapse (SLAC).

Wrist OA from 3 types of insult:
  1. Ligament injuries –
  2. Fractures –
    • Chondral lesions following carpal bone fractures
    • Distal radius fracture, distal ulna fracture
    • Scaphoid fractures with nonunion leading to scaphoid nonunion collapse (SNAC) wrist
  3. Vascular supply –
Classic history and presentation: Patients will typically present with pain, swelling, stiffness, loss of mobility, and decreased strength.

Prevalence: The prevalence of wrist OA varies within the literature; however, one study found that 1.7% of men and 1.0% of women have wrist OA confirmed radiographically.

Risk factors:
  • Modifiable: high body mass index (BMI), occupation
  • Nonmodifiable: trauma, advanced age, genetics, joint shape
Pathophysiology: The underlying pathophysiology is the loss of articular cartilage, which leads to clefts within the cartilage and exposure of bony surfaces. Activation of enzymes and chemical factors that govern cartilage strength and integrity are involved, leading to fractures of superficial cartilage and decreased bone thickness.


M19.039 – Primary osteoarthritis, unspecified wrist

1771000119109 – Arthritis of wrist

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:05/18/2022
Last Updated:09/27/2022
Copyright © 2023 VisualDx®. All rights reserved.
Osteoarthritis of wrist
Copyright © 2023 VisualDx®. All rights reserved.