Radial ray anomaly

Case contributed by Dr Pir Abdul Ahad Aziz Qureshi

Presentation

Congenitally deformed upper limbs with deviated hands bilaterally

Patient Data

Age: 7 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

X-ray

Complete absence of the radius bilaterally, with absent thumb on left side. Absence of multiple carpal bones bilaterally. Bowing hypoplastic ulna with poor support to wrist joint bilaterally, resulting in radial deviation and hyperflexion of both hands. Findings are suggestive of Type IV Radial Ray Anomaly. 

Case Discussion

Radial ray anomalies can be classified according to their severity into four main subtypes :

  • type I: slightly (>2 mm) short radius and sideways bending of hands at the wrist (often associated with a hypoplastic thumb); proximal radius is usually unaffected.
  • type II: very short radius and sideway curving of ulna which supports the wrist poorly
  • type III: partial absence of radius 
  • type IV: complete absence of radius 

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