X-ray right wrist and hand
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There is a widened scapholunate distance with proximal subluxation of the capitate and altered contours of the scaphoid and lunate bones. Additionally, subchondral cystic changes are demonstrated throughout the bones of the carpus and also in the distal ulna. Convexity of the pronator fat-pad suggests a wrist joint effusion, although the soft tissues around the joint are oedematous. Scattered densities through the joint spaces, particularly in the TFCC, and calcific density posterior to the carpus are of uncertain significance and may represent soft tissue/cartilage calcification or remnants of old trauma.
These findings may represent changes after previous trauma (particularly rupture of the scapholunate ligament) or crystal deposition disease (such as pyrophosphate arthropathy). The metacarpals and phalanges are relatively unaffected. Osteoarthritic changes are noted at the first carpometacarpal and several distal interphalangeal joints. No definite acute bony injury is demonstrated.