This patient had a history of trauma as a child and his adult wrist has marked ulnar tilt of the radiocarpal articulation reminiscent of Madelung deformity. The distal ulna also appears dysmorphic.
A careful study of the wrist, though, shows that many of the features of Madelung deformity are absent:
- no dorsal subluxation of the distal ulna and positive ulnar variance
- no wedging of the carpus between the radius and ulna
- no dorsal and radial bowing of the radius
- no failure of ossification of the ulnar side of the distal radial epiphysis
- no “V-shaped” proximal carpal row (herniated proximal carpal row)
In fact, the carpals appear pretty much normal, although they are ulnarly displaced.