144 patients with post-traumatic wrist pain but normal standard radiographs were examined by wrist arthroscopy. Ligamentous lesions were observed in 75 patients. TFCC lesions, classified according to the Palmer classification and including lunato-triquetral interosseous ligament lesions, were seen in 61, and scapho-lunate interosseous ligament lesions in 14 patients. Degenerative TFCC changes were equally common in patients younger than 40 years of age but significantly more common with more than 2 years duration of symptoms. Varying degrees of instability were noted in patients with scapho-lunate interosseous ligament lesions but no associated ligament lesions were observed. Because of the variety of pathological changes arthroscopy is recommended in the management of patients with post-traumatic wrist pain.