Wrist Osteoarthritis Patterns: Diagnosis and Imaging-Guided Management

Wrist osteoarthritis most often develops as a secondary condition resulting from ligamentous injury or fracture-related complications, rather than as primary idiopathic degeneration. Failure of specific intrinsic and extrinsic stabilizers, as well as scaphoid nonunion or malunion after distal radius fractures, leads to predictable biomechanical alterations that drive progressive carpal collapse and compartmental joint degeneration. Distinct instability-related patterns-including scapholunate advanced collapse, hamate arthrosis lunotriquetral ligament tear, and scaphotrapeziotrapezoid osteoarthritis advanced collapse-and fracture-related patterns, such as scaphoid nonunion advanced collapse and post-distal radius malunion osteoarthritis, progress through characteristic sequences of articular involvement with important diagnostic and therapeutic implications.