In a normal joint the articulating bone ends are covered with a smooth layer of cartilage which allows free and painless movement. In osteoarthritis (degenerative arthritis) the cartilage thins and eventually the bone ends articulate against each other. The joint capsule may also thicken and there may be additional bone formation. The result is pain, stiffness, loss of movement and in some cases deformity. This joint is the second most common site in the body for osteoarthritis with nearly all individuals aged 65 affected but fortunately only a few are symptomatic.

The scaphoid bone is an important structure because it links the two rows of bone forming the wrist. It is therefore subjected to large mechanical loads and also has an unusual blood supply which can impede its ability to heal. Scaphoid fracture normally occurs as a result of a fall on an outstretched hand. Pain, swelling and limitation of movement are normally apparent, although in some cases this is not obvious and therefore this fracture is commonly missed.

The extensor tendons to the thumb run through a tunnel system at the level of the wrist. Thickening of the tendon or narrowing of the tunnel may interfere with tendon gliding, resulting in pain, loss of movement, clicking or grinding.

A ganglion is a thin walled cyst containing jelly like material. It can arise from a joint or tendon sheath. It is usually degenerative. Occasionally, it may follow trauma.

A ganglion is a thin wall cyst containing jelly like material. It can arise from a joint or tendon sheath. It is usually degenerative. Occasionally it may follow trauma. This ganglion can normally been seen or felt over the front of the wrist. It may fluctuate in size and cause pain that radiates up into the arm or down into the hand.

The triangular fibrocartilage complex (TFCC) is a strong gristle like disc that links the forearm bones together at the level of the wrist. It’s a complex structure that contributes to joint stability, as well as providing an articulating surface for the wrist and forearm bones. TFCC tears are usually the result of a fall on an outstretched hand. They are one of several types of so-called ‘wrist sprains’. These tears make wrist movements painful and cause loss of forearm rotational movement.

This technique, also known as keyhole surgery, involves the insertion of a tiny telescope into the wrist joint. It’s an advanced diagnostic tool that allows direct visualisation and probing of joint surfaces, ligaments and other structures within the wrist. In combination with an MRI scan, it allows a comprehensive assessment of a troublesome wrist. Treatment for the problem can be undertaken at the same time with small instruments. This avoids large incisions and generally leads to quicker recovery times.