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Have crepiitus cracking sounds in wrist and upper arm. CT scan, MRI done. What is the problem?

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Practicing since : 2007
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I am a boilermaker age 61 years and have crepiitus cracking sounds in wrist and upper arm CT Scan has revealed problems to its degree and has suggested that II have an MRI done for further clarity and some possible repairs before my return to work However one of the specialists without even seeing the Doctors referral or the CT just deemed it unnecesary to have an MRI done. Would you recomend Doctor that I have it done and get an experts opinion of what it may take to get this very uncomfortable position repaired and as it has income protection insurance cover prior to my return to work regards XXXXXX, thank you doctor.
Posted Mon, 6 May 2013 in Bones, Muscles and Joints
Answered by Dr. Ganesh Sanap 5 hours later
Hi, welcome and thanks for writing in.
It looks you have suffered significant trauma to hand. In such case it is always better to do both CT and MRI. However it also depends on clinical condition.
Can you please upload or write your ct scan report briefly. It will definitely clarify the need for further investigation. Also mention present symptoms like swelling, fever, difficulty in movement or any?

Looking forward for your response.

Above answer was peer-reviewed by
Follow-up: Have crepiitus cracking sounds in wrist and upper arm. CT scan, MRI done. What is the problem? 15 hours later
Dear Doctor, palpable crepitus with flexion and extension of the wrist at radio carpal joint. Moderate OA features of the radiocarpal joint space.Evidence of ulnolunate abutment with mod OA change of the first CMC joint space. A schapotrepezium joint space. Schaphoid and lunate bones are anteriorly positioned rel to the radius. The structures in the carpal tunnel although it is difficult appear to be unremarkable within limitations of the scan. Distal rad frac has healed. The pain I am feling is in my wrist and the base of my thumb is OA probably long standing. Fracture has caused exacerbation of this that is as yet unrelenting. Will have no significant improvement from the OA that he feels. Basic overview is regular Analgesia right through to operative management of the wrist. And anti-inflammatories.

The next Doctor after saying MRI not neccessary suggested if symptoms too bad we could consider salvage surgery in the form of a radioscapholunate fusion, what are your views please Doctor and how will it inhibit movement in my hand and wrist regards XXXXXX.
Answered by Dr. Ganesh Sanap 8 hours later
Hi, welcome back.
Trauma followed by such changes of osteoarthritis is quite difficult to manage. Your orthopaedician is nearly correct regarding the management. In such cases most orthopaedician do not require MRI due to their clinical judgement. Also MRI is usually useful in ligaments and muscle injury in acute trauma. It will not help too much in your case at this time.
I will suggest you can follow your orthopaedician opinion as symptomatic relief needs operation. Also osteoarthritis is better diagnosed on CT SCAN.

Hope I have answered your query. If you have further concern, please let me know.

Above answer was peer-reviewed by
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