Dr. Timothy K. Durnin - 3/2/2009

Question
I injured my wrist approx. 5 months ago, I had negative x-rays soon after the injury and did not seek any further treatment, however, it has been painful when I twist, strain, or have resistance to it so I was sent for an MRI - I have copied the "findings" below -

"Mildly abnormal marrow of the lunate carpal bone with no fracture, possibly a contusion"

This wasn't a high impact injury, since he says "possible contustion", what are the other possibilities, should I request a different test or is it normal for a contusion to take this long to heal?  

Answer
Hi Nicole,

Very good question, the MRI isn't sensitive enough to pick up many hairline fractures, periosteal tearing or other micro traumas. A bone SPECT will. Depending on where you live, this may or may not be available. Regardless, it will not make a difference on what you need to do to heal the injury. Advanced imaging such as a SPECT is done to show objective injury for third party payers such as Workman's Comp or personal injury. What you must do is avoid re-injury and let it heal, this may take a great deal of addition time, but avoid anything that triggers pain in that wrist. When it gets better, have it mobilized by a Chiropractor at least once a month to prevent osteoarthritis from setting in. The body will heal itself, you just have to make sure it heals correctly without residuals such as OA. Try to obtain an air splint or air cast that you can remove daily and use only when active. They cost about $45 and come with a squeeze pump that lets the air in and out with Velcro stays for easy removal. Doing this in combination with ice and therapeutic ultrasound will speed things up. The MRI only shows a "bruised wrist bone" so it needs time to heal. These injuries seem like they take forever to heal because they have a very poor blood supply, this is countered with ultrasound. You can also just wait out the time and avoid physiotherapy all together, the choice of course is yours. Either way, it will heal if rested.

Look forward to much better days in the near future, this will resolve, just listen to your body and rest it.

Good luck,

Dr. Timothy Durnin