Swelling of the wrist joint is a common clinical symptom and can result from a wide variety of causes — from trauma and overuse to inflammatory, infectious, or neoplastic conditions. Understanding the location, duration, associated symptoms, and patient history is essential for diagnosis.
Fractures (e.g., distal radius or ulna)
Ligament injuries (e.g., scapholunate ligament tear)
Tendon injuries or sprains
Hemarthrosis (bleeding into joint space)
Clues: Sudden swelling after trauma, pain, bruising, decreased motion.
Osteoarthritis – typically affects older adults; bony swelling, reduced ROM, crepitus.
Tendinitis / Tenosynovitis.
De Quervain’s tenosynovitis (radial wrist pain/swelling).
Flexor or extensor tendon sheath inflammation.
Clues: Chronic swelling, worse with activity, localized tenderness.
Rheumatoid arthritis (RA)
Commonly affects the wrist bilaterally.
Swelling is soft, boggy, with pain, morning stiffness.
Psoriatic arthritis.
Systemic lupus erythematosus (SLE).
Gout or pseudogout – acute, very painful swelling, redness.
Clues: Bilateral involvement, systemic symptoms, joint deformity.
Infection within the joint capsule.
Usually caused by bacteria (e.g., Staph aureus).
Rapid onset of pain, warmth, swelling, and fever.
Clues: Very tender, red, hot wrist; fever; medical emergency.
Benign, fluid-filled swelling from joint or tendon sheath.
Usually dorsal (back of the wrist), but can be volar.
Soft or firm, may fluctuate in size.
Clues: Non-tender or mildly tender, moves with wrist movement.
Rare, but includes:
Giant cell tumor of tendon sheath
Lipomas
Synovial sarcoma (malignant, very rare)
Clues: Painless swelling, gradually increasing in size, may be firm.
Lymphedema, renal disease, heart failure
Bilateral, pitting swelling of hands/wrists
Cause – Treatment
Trauma – Immobilization, surgery if needed
Arthritis – NSAIDs, DMARDs (e.g., methotrexate), physiotherapy
Gout – Colchicine, allopurinol, NSAIDs
Ganglion cyst Observation, aspiration, surgery if symptomatic
Infection IV antibiotics, joint washout.
Tumors – Surgical excision, biopsy if suspicious