29840 Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)

Name of the Procedure:

Arthroscopy, Wrist, Diagnostic, with or without Synovial Biopsy
Common names: Wrist Arthroscopy, Diagnostic Wrist Arthroscopy, Arthroscopic Synovial Biopsy

Summary

Arthroscopy of the wrist is a minimally invasive surgical procedure that allows doctors to view and diagnose issues inside the wrist joint using a small camera called an arthroscope. During the procedure, a biopsy of the synovial tissue may also be performed if needed.

Purpose

The procedure is used to diagnose and treat various wrist issues such as persistent pain, swelling, or joint instability. It can help identify problems like inflammation, cartilage damage, or ligament tears. The goal is to provide an accurate diagnosis and, if necessary, therapeutic intervention.

Indications

• Chronic wrist pain
• Swelling or inflammation
• Limited range of motion
• Suspected ligament or cartilage damage
• Unclear MRI or X-ray results
• Need for synovial biopsy to diagnose conditions like rheumatoid arthritis or other inflammatory diseases

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments may be required, particularly for blood thinners.
• Pre-procedure evaluations like blood tests or wrist imaging may be necessary.

Procedure Description

1. The patient is usually given regional anesthesia or general sedation.
2. Small incisions are made around the wrist to allow insertion of the arthroscope and instruments.
3. The arthroscope transmits images to a monitor, allowing the surgeon to inspect the joint.
4. If a synovial biopsy is needed, specialized tools collect tissue samples.
5. The instruments are removed, and the incisions are closed with stitches.
6. A sterile bandage is applied to the wrist.

Duration

The procedure typically takes around 30 minutes to an hour.

Setting

Arthroscopy is usually performed in an outpatient setting, such as a hospital or a surgical center.

Personnel

• Orthopedic surgeon or hand surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the incision site
• Bleeding or blood clots
• Nerve injury
• Persistent pain or stiffness
• Complications from anesthesia

Benefits

• Minimally invasive with faster recovery times compared to open surgery
• Accurate diagnosis of wrist conditions
• Potential for therapeutic intervention during the same procedure

Recovery

• Post-procedure, the wrist is usually bandaged and may be placed in a splint.
• Pain management involves medications and ice packs.
• Patients should avoid heavy lifting and strenuous activities for a few weeks.
• Follow-up appointments are necessary to monitor healing and remove stitches.

Alternatives

• Non-surgical treatments (e.g., physical therapy, medications)
• Traditional open surgery (more invasive with longer recovery)
• Imaging tests alone (less accurate for detailed diagnosis)

Patient Experience

• Patients may feel pressure but should not experience significant pain during the procedure due to anesthesia.
• Mild discomfort and swelling are common after the procedure, managed with medications and rest.
• Clearer diagnosis and relief of symptoms often result in improved function and pain levels over the following weeks.