Hand and wrist assessment is the first step towards safe, effective treatment. During your visit, our surgeons and specialist therapists listen to your story, examine the joints, check blood flow and nerves, then order the right scan. This leaflet explains every stage so you know what to expect and how to prepare.
WHY A STRUCTURED ASSESSMENT HELPS YOU
• Confirms the exact cause before treatment begins• Detects urgent problems such as poor blood flow or hidden fractures
• Prevents long-term stiffness by guiding early therapy
• Gives you the knowledge to take an active role in recovery
WHAT HAPPENS IN CLINIC?
- Your History
– Onset of pain, injury or tingling
– Triggers such as sport, typing or cold weather
– Any colour changes, night pain or swelling - Inspection and Palpation
– Skin colour, scars, swelling, nail health
– Gentle pressure locates tender spots and warmth - Movement and Function
– Bending, straightening and twisting the wrist and fingers
– Grip strength and tasks such as picking up a coin - Nerve and Blood-Flow Checks
– Radial and ulnar pulses at the wrist
– Capillary refill: nail bed should pink up within three seconds
– Modified Allen test: confirms both main arteries can supply the hand; quick and painless
KNOW YOUR BLOOD SUPPLY
• The brachial artery divides at the elbow into the radial (thumb side) and ulnar (little-finger side) arteries.• Inside the palm, they form two arches that feed the fingers.
• Good dual supply protects the hand if one artery is used for a drip, fracture fixation or a bypass graft.
COMMON IMAGING TESTS
Plain X-ray – Shows bones; rules out fractures and arthritis.Ultrasound with Doppler – Sees tendons, cysts and live blood flow.
CT or CT angiography – 3-D bone detail and larger artery injuries.
MRI or MR angiography – Best for soft tissues, ligaments and small vessels; no radiation.
CHOOSING THE RIGHT TEST
Our team balances safety, accuracy and cost. For example, suspected scaphoid fractures start with an X-ray; persistent pain moves the plan to an MRI. See our Scaphoid Fracture Leaflet for details.HOW TO PREPARE
• Bring earlier scans or letters.• Remove rings and watches before imaging.
• Tell staff about pregnancy, kidney problems or metal implants.
• Most ultrasound and X-ray tests need no fasting; CT with dye may need short fasting.
QUESTIONS TO ASK
• What does the test involve and how long will it take?• Will I feel any discomfort or need an injection?
• What are the possible findings and next steps?
• How and when will I receive the results?
CLINICAL PEARLS / KEY POINTS
• Always compare both hands; subtle swelling stands out.• Fingers that turn white or blue in the cold may signal Raynaud’s phenomenon – mention this to your surgeon.
• Capillary refill taking longer than three seconds needs urgent review.
• Ultrasound accuracy improves with an experienced sonographer.
PATIENT FAQS
Why do my fingers change colour in the cold?A temporary spasm of small arteries, called Raynaud’s phenomenon, can make fingers go white or blue. It is usually harmless but worth discussing with your clinician.
Will every scan need an injection?
No. Standard X-ray and MRI require no injections. CT angiography and some MRI scans use a contrast dye; you will be told beforehand.
Is the Allen test really necessary?
Yes. It proves that both arteries can keep your hand safe if one is used for an arterial line, fracture surgery or graft. The test is swift and painless.
Can metal plates from an old fracture stop me having an MRI?
Modern titanium and surgical stainless-steel plates are usually MRI-safe. Tell the radiographer so the correct settings can be used.
CALL-TO-ACTION
For expert assessment or to book an appointment, phone 020 3384 5588, email Info@TheArmDoc.co.uk or visit www.TheArmDoc.co.uk for trusted exercise videos and upper-limb care tips.DISCLAIMER
This leaflet offers general information and does not replace personalised medical advice. Always follow the recommendations of your healthcare professional.