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Wrist pain, episodes of GOUT. X-ray showed arthritic changes. Have scaphoid fracture. Explain

My husband has been suffering from right wrist pain for over one month now. Initially, his wrist was very swollen and red. Since he has a history of a couple of episodes of gout (ankles), it was assumed he was having a gout flare in the wrist. He has been on Relafen and took Colcrys for two weeks, with no relief. An xray showed an old fracture of the scaphoid bone , with necrosis to the head of the scaphoid and some arthritic changes. He saw an orthopedic surgeon who believes gout is causing his pain in his wrist, but surgery may be needed for the old fracture. He was given a steroid injection in his wrist, and it s been 6 days with no relief. He has completely lost the use of his right hand due to this problem. Could the scaphoid fracture be causing all of his pain? It has been 15 years since the injury likely occurred.
Asked On : Sat, 2 Mar 2013
Answers:  2 Views:  65
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Orthopaedic Surgeon, Joint Replacement 's  Response
Feb 2014
Thanks for writing to us
Pain in his wrist could be due to avascular necrosis of scaphoid. MRI wrist might be helpful to see the grade of avascular necrosis. I suggest you to consult this possibility with your orthopaedic surgeon and definitive treatment plan according to that.
I do hope that you have found something helpful and I will be glad to answer any further query.
Answered: Wed, 28 Aug 2013
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Orthopaedic Surgeon, Joint Replacement Dr. K. Naga Ravi Prasad's  Response
Jul 2013
Hi, thanks for writing to HCM.

It's very unlikely that a 15 year old scaphoid fracture will produce so much of an acute inflammatory response leading to severe pain & swelling of the wrist.

I attribute all the symptoms of your husband to a gout flareup.

NSAID's form the first line of therapy in the management of acute gout flareup. A potent NSAID (such as naproxen 500 mg twice daily or indomethacin 50 mg three times daily)is generally indicated for reduction of acute gouty inflammation. The NSAID can be discontinued one or two days after clinical signs have completely resolved. Typically, the total duration of NSAID therapy for an acute attack is five to seven days.

Use ice packing of the wrist once in 2 hours to reduce the pain and swelling.

Hope this information is helpful. Good day
Answered: Wed, 28 Aug 2013
I find this answer helpful
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