Your doctor can diagnose carpal instability by reviewing your medical history and performing an examination. If you experienced a wrist injury, you should tell your doctor about how it occurred.
Your doctor will feel the ligaments and bones in your hand to pinpoint the source of pain. Your doctor will maneuver the carpal bones to diagnose specific areas of instability.
Your hand will be X-rayed to determine the position and condition of the carpal bones. You may receive other imaging tests, such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, arthrograms and ultrasound.
Your doctor will classify the instability pattern of your carpal bones. There are several types of carpal instability patterns, including dissociative carpal instability, nondissociative carpal instability, ulnar translocation, and dorsal subluxation. Dissociative carpal instability results in instability between the carpal bones that are within a row. Nondissociative carpal instability is instability that occurs between the two rows of carpal bones. Ulnar translocation describes a shift in the carpal bones to the little finger side of the hand. Ulnar translocation can result from rheumatoid arthritis. Dorsal subluxation describes an upward shift in the carpal bones that can occur after a wrist fracture.
Carpal instability is further classified as static or dynamic. Static instability is apparent on an X-ray when the hand is motionless. If a doctor can move the carpal bones during maneuvering tests, it is termed a dynamic carpal instability.