Scapholunate advanced collapse and scaphoid non-union

Case contributed by Assoc Prof Craig Hacking

Presentation

Chronic radial-sided wrist pain.

Patient Data

Age: 50 years
Gender: Male

Increased sclerosis of the proximal pole of the scaphoid with evidence of a waist fracture in keeping with non union and AVN of the proximal pole. There is also widening of the scapholunate interval. Joint space narrowing, osteophytosis and mild subchondral sclerosis of the radioscaphoid articulation in keeping with osteoarthritis.

1 year earlier

X-ray

Impacted fracture of the scaphoid waist. Widening of the scapholunate interval.

Case Discussion

Degeneration of the radioscaphoid articulation is the first stage of a SLAC and SNAC wrist. In this case, the cause is SLAC as the widening that the capitate will migrate proximally through is the scapholunate interval rather than the un-united scaphoid fracture.

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