Presentation
Fall onto a hyperextended hand, delay in seeking treatment.
Patient Data
scaphoid waist nonunion fracture associated with pseudoarthrosis and early degenerative changes
volar subluxation of the distal scaphoid fragment resulting in a secondary humpback-type deformity
T1 marrow signal of the proximal pole of the scaphoid is consistent with scaphoid viability
the scapholunate ligament is normal
the lunate is dorsally tilted associated with increased capitolunate angle measuring about 44o (normal <30o) and scapholunate angle measuring about 98o (normal <60o) suggesting dorsal intercalated segment instability (DISI)
the extensor carpi ulnaris (ECU) tendon demonstrates medial palmar subluxation from its fibro-osseous tunnel
there is a fluid containing structure next to the ulnar styloid having a narrow tail connected to the ulno-carpal joint
there is also abnormal signal intensity at the triangular fibrocartilage suggesting ligamentous injury
Case Discussion
Imaging findings are consistent with the scaphoid waist chronic fracture with pseudoarthrosis and humpback deformity. Normal T1 marrow signal in the proximal scaphoid pole with no collapse or significant sclerosis is a useful marker in assessing scaphoid viability, but it is not always 100% specific.
Unable to process the form. Check for errors and try again.