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M77.2 Periarthritis of the Wrist – ICD-10
M77.2 is the ICD-10 code for periarthritis of the wrist – an inflammation of the soft tissues surrounding the wrist joint, causing pain and restricted movement.
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M77.2 is the ICD-10 code for periarthritis of the wrist – an inflammation of the soft tissues surrounding the wrist joint, causing pain and restricted movement.
What is M77.2?
The ICD-10 code M77.2 refers to periarthritis of the wrist. This condition involves inflammation of the soft tissue structures surrounding the wrist joint, including tendons, tendon sheaths, ligaments, and adjacent connective tissue. The joint surfaces themselves are not primarily affected. The condition can be acute or chronic and is commonly associated with significant pain and reduced range of motion.
Causes
Periarthritis of the wrist can be triggered by a variety of factors:
- Overuse and repetitive movements: Manual workers, office employees, and athletes who frequently strain the wrist are at increased risk.
- Trauma: Falls, sprains, or direct injuries to the wrist area can trigger periarthritis.
- Inflammatory underlying conditions: Diseases such as rheumatoid arthritis or gout can affect the periarticular structures.
- Metabolic disorders: Diabetes mellitus and thyroid disorders are recognised risk factors for tendon pathologies.
- Idiopathic: In some cases, no clear cause can be identified.
Symptoms
Typical complaints associated with M77.2 include:
- Pain in the wrist area, especially during movement or physical stress
- Tenderness over the affected tendons or ligaments
- Swelling or mild redness around the wrist
- Restricted range of motion (e.g., when flexing, extending, or rotating the wrist)
- Morning stiffness that may improve throughout the day
- In some cases, a palpable or audible grinding sensation (crepitation) during movement
Diagnosis
Diagnosis of periarthritis of the wrist is typically made through a combination of:
- Medical history: Assessment of symptoms, occupation, physical activities, and pre-existing conditions.
- Physical examination: Evaluation of range of motion, tenderness, and swelling.
- Imaging: X-rays to rule out bony causes, ultrasound to assess tendons and tendon sheaths, and MRI if findings remain unclear.
- Laboratory tests: Blood tests to rule out inflammatory or rheumatic conditions (e.g., ESR, CRP, rheumatoid factor).
Treatment
Treatment depends on the underlying cause and severity of the condition:
Conservative Treatment
- Rest and immobilisation: Avoiding pain-triggering movements and temporarily immobilising the wrist with an orthosis or splint if necessary.
- Physiotherapy: Targeted exercises to restore mobility, strengthen, and stretch the affected structures.
- Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac to relieve pain and reduce inflammation.
- Local injections: Corticosteroid injections into the affected area may be used for treatment-resistant cases.
- Cold and heat therapy: Cooling for acute inflammation, heat application for chronic complaints to relieve stiffness.
Surgical Treatment
Surgery is rarely required and is only considered in severe, treatment-resistant cases, for example where there is structural damage to tendons or ligaments.
Prognosis
The prognosis for M77.2 is generally good. With consistent conservative treatment and modification of strenuous activities, symptoms often resolve completely. Chronic progression is possible if the underlying cause is not addressed or if a systemic condition is present.
References
- World Health Organization (WHO): International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) – M77.2 Periarthritis of wrist. www.who.int
- Niethard, F. U., Pfeil, J., Biberthaler, P.: Duale Reihe Orthopädie und Unfallchirurgie (Orthopaedics and Trauma Surgery), 8th edition. Thieme Verlag, Stuttgart 2017.
- Dacre, J. E., Beeney, N., Scott, D. L.: Injections and physiotherapy for the painful stiff shoulder. Annals of the Rheumatic Diseases, 1989; 48(4):322–325. PubMed PMID: 2757033.
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