Presentation
X-rays for exclusion of a fracture following blunt trauma. There is a known congenital deformity of bilateral forearms.
Patient Data
The forearms demonstrate bilateral skeletal abnormalities:
absence of the radius
shortening of the forearms
ulna hypertrophy, shortening and mild bowing
ulna carpal fusion on the left and an ulna carpal pseudoarthrosis on the right
absent carpal bones - (usually scaphoid and trapezium)
radial deviation of the wrist
abnormal, short and "floating" thumbs (there is a proximal and terminal phalanx on the right with an abnormal first metacarpal, while there is a terminal phalanx on the left with abnormal proximal phalanx and absent first metacarpal)
There are no acute or occult post traumatic bony abnormalities.
Image courtesy: Dr S Palliam.
Case Discussion
Features consistent with a type IV radial dysplasia 3 with the complete absence of the radius bilaterally. There are associated skeletal deformities and abnormalities as described.
Aberrant muscles, tendons, nerves, ligaments and blood vessels are often also present with complete radial absence.
In this instance, there is no known associated congenital disorder at the time of presentation.