Humpback deformity of scaphoid

Case contributed by Dr Andrew Lawson

Presentation

Wrist pain after fall.

Patient Data

Age: 24
Gender: Male
X-ray

Fractured scaphoid. Does it look acute or chronic.

CT

Fracture through the waist with sclerosis. This is an old, non-united scaphoid fracture.

MRI

The fracture line through the waist of the scaphoid is again demonstrated with volar subluxation of the distal scaphoid fragment resulting in a secondary humpback type deformity. Chronic non-union has resulted in a pseudo-arthrosis at the level of the waist. T2 marrow oedema in the proximal pole of the scaphoid is consistent with scaphoid viability. Focal T1 low signal along the distal scaphoid pole is consistent with either early degenerative change or results from a previous fracture. The scapholunate ligament and alignment are normal. The TFCC complex is intact.

Comment Chronic waist of scaphoid fracture pseudoarthrosis with humpback deformity. Normal marrow signal in the proximal scaphoid pole with no collapse or significant sclerosis which are findings consistent with scaphoid viability.

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Case information

rID: 26847
Case created: 10th Jan 2014
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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