SURGEONS DECISION-MAKING IN PATIENTS WITH CHRONIC WRIST PAIN - ROLE OF BILATERAL 3-COMPARTMENT WRIST ARTHROGRAPHY - PROSPECTIVE-STUDY

PURPOSE: To determine if wrist arthrography changes surgeons' diagnose s and treatment plans for patients with chronic wrist pain. MATERIALS AND METHODS: Bilateral, three-compartment wrist arthrography was perfo rmed in 64 patients. Prospective questionnaires evaluated surgeons' di agnoses and management plans at three stages: before arthrography, aft er arthrography of the symptomatic wrist, and after arthrography of th e asymptomatic wrist. RESULTS: Surgeons tended to plan more conservati ve management after receiving the results of arthrography. The number of patients for whom the reported treatment plan included surgery drop ped from 28 of 64 patients (44%) to 19 of 64 patients (30%) after revi ew of the arthrography results (P = .05). The number of patients for w hom the treatment plan included treatment of any kind dropped from 55 of 64 patients (86%) to 49 of 64 patients (77%) after review of the ar thrography results (P = .09). An overall change in treatment plan occu rred in 29 of 64 patients (45%). CONCLUSION Wrist arthrography influen ces surgeons' decision making. After reviewing the results of arthrogr aphy, surgeons tended to change treatment plans toward more conservati ve, less invasive treatment.