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Non-dissociated dorsal intercalated segmental instability

Case contributed by: Dr Charlie Chia-Tsong Hsu

Presentation:

86 year-old female with chronic left wrist pain.

Patient Data:

Gender: Female

Race: Caucasian

From the case: Non-dissociated dorsal intercalated segmental instability

Modality: X-ray

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Anteroposterior radiograph of the wrist demonstrates narrowing of the scaphoid-radial articulation with subchondral sclerosis. The carpal arcs are maintained with all the carpal bones parallel to each other. There is osteoarthritic changes at the base of the 1st metacarpal.

The lateral view demostrates dorsally angulated lunate with increase capitolunate and scapholunate measuring 26 and 70 degrees respectively. The normal capitolunate angle is less than or equal to 20 and normal scapholunate angle is between 30-60.