Patients with chronic carpal instability usually present with complaints of pain in the wrist. This may be constant or associated with heavier activities. Their complaints may have been present for weeks, months, or even years. Although some patients may recall a specific injury to their wrist, many are unable to recall any significant injury. Depending on the type of instability (scapholunate, lunotriquetral, midcarpal, etc.), the pain may be located on the radial or ulnar aspect of the wrist. Patients may report a clicking or popping in their wrist with certain activities.

A detailed examination of the wrist should be performed. This should include objective documentation of range of motion. Pain in certain positions of wrist motion should be noted. Tenderness should be elicited over the first dorsal compartment, the snuffbox, the scapholunate interval, the lunotriquetral interval, the distal radioulnar joint (DRUJ), the triangular fibrocartilage complex (TFCC), the pisotriquetral joint, and the midcarpal joint. Evaluation for
instability should be performed with the scapholunate instability, lunotriquetral shuck, and midcarpal instability tests. Comparison with the normal opposite wrist should be made.