Presentation
2/52 monoarthritis right wrist with dorsal wrist swelling
Patient Data
Right Wrist: There is a stage III (Watson) SLAC wrist pattern. Advanced change of osteoarthritis are seen at the articulation between the distal radius and scaphoid with a large subchondral cyst in the scaphoid bone. Calcification is seen in the triangular fibrocartilage and over the dorsum of the wrist. Mild changes of osteoarthritis are present at the first CMC joint.
In the absence of a history of trauma from the patient, appearances are typical for a CPPD arthropathy.
Case Discussion
This case shows classic features of a CPPD (calcium pyrophosphate deposition) arthropathy at the wrist with loss of cartilage between the scaphoid and distal radius associated with subchondral sclerosis and large subchondral cysts. In adition there is loss of cartilage with subchiondral sclerosis between the capitate and lunate. The scaphoid lies more proximally and the lunate more distally, disrupting the carpal arcs of Gilula.
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