Article: Although the above information can help you understand if your wrist is sprained and roughly gauge to what extent, your doctor is much more qualified to make an accurate diagnosis. In fact, a detailed history leads to a specific diagnosis in about 70% of wrist pain cases. Your doctor will examine your wrist and perform some orthopedic tests on it, and if the injury appears severe, they will likely send you for a wrist x-ray to rule out a fractured bone. X-rays only show bones, however, and not soft tissues such as ligaments, tendons, blood vessels, or nerves. Broken carpal bones, particularly hairline fractures, can be tricky to see on x-ray because of their small size and the confined space. If the x-rays are negative for a wrist fracture, but your injury is severe and in need of surgery, the doctor might send you for an MRI or CT scan. Small stress fractures of carpal bones (particularly the scaphoid bone) are very difficult to see on regular x-rays until all the inflammation fades away. Thus, you may have to wait a week or so to get another x-ray. These types of injuries may also require additional imaging such as MRI or splinting/casting depending on severity of symptoms and mechanism of injury. Osteoporosis (a condition characterized by demineralization and brittle bones) is a significant risk factor for wrist fractures, although it doesn't increase the risk of wrist sprains. For all Grade 1 wrist sprains and most Grade 2 sprains, there's no need for an MRI or other high-tech diagnostic test because the injuries are short-lived and tend to heal within a few weeks without any medical treatment. However, for more serious ligament sprains (especially Grade 3 varieties) or if the diagnosis remains unclear, then magnetic resonance imaging (MRI) is warranted. An MRI uses magnetic waves to provide detailed images of all structures within the body, including soft tissues. MRI is great for visualizing which ligament is badly torn and to what extent. This is very helpful information for an orthopedic surgeon if surgery is required. Tendinitis, ruptured tendons and bursitis of the wrist (including carpal tunnel syndrome) mimic wrist sprains, but an MRI can distinguish between the different injuries. An MRI is also helpful to see the extent of blood vessel and nerve damage, particularly if your wrist injury is causing symptoms in your hand, such as numbness, tingling and/or loss of normal color. Another cause of wrist pain that can mimic a low-grade sprain is osteoarthritis the wear and tear type. However, osteoarthritis pain is chronic, gets slowly worse over time and typically involves a grinding feeling with wrist movement. If your wrist injury is pretty severe (and not improving) and the diagnosis remains unclear after x-rays and an MRI, then further imaging modalities such as a CT scan are indicated. Computerized tomography (CT) scans combine x-ray images taken from different angles and use computer processing to create cross-sectional images (slices) of all hard and soft tissues inside your body. CT images provide more detailed information than regular x-rays, but similar levels of detail to MRI images. In general, CT is excellent for evaluating hidden fractures of the wrist, although MRI tends to be better for evaluating more subtle ligament and tendon injuries. However, CT scans are typically less expensive than MRI, so this may be a factor if your health insurance won't cover costs of diagnosis. CT scans expose you to ionizing radiation. The amount of radiation is more than plain x-rays, but not enough to be considered harmful. The most common ligament sprained in the wrist is the scapho-lunate ligament, which connects the scaphoid bone to the lunate bone. If all the above mentioned diagnostic imaging results are negative, but your severe wrist pain persists, then your doctor will likely refer you to an orthopedic (bone and joint) specialist for more testing and evaluation.

What is a summary?
Consult with your family physician. Get a referral for an MRI. Consider a CT scan.