Scapholunate advanced collapse (SLAC)

Case contributed by Dr Benoudina Samir

Presentation

65 year old man. Increasing pain and swelling of the wrist. History of a very old trauma.

Patient Data

Age: 65
Gender: Male

Frontal view:

  • Loss of parallelism of the first and second carpal arcs of Gilula
  • The radiolunate articulation is widened.
  • Advanced degenerative arthritis in the radioscaphoid and capitolunate articulations.
  • Collapse of mid-carpal joint.

Lateral view:

Annotated image

Annotated

On the frontal view:

  1. Stylo-scaphoid osteoarthritis.
  2. Radio-scaphoid osteoarthritis.
  3. Capitolunate osteoarthritis.

On the lateral view:

  • Dorsal tilting of the lunate with dorsal subluxation of the capitate.
  • DISI deformity.

 

 

Case Discussion

SLAC (scapholunate advanced collapse) refers to a specific pattern of degenerative arthritits and subluxation which results from untreated chronic scapholunate dissociation.

Watson staging is often used by hand surgeons: 

  • I: osteoarthritis of the articulation between the radial styloid and the scaphoid
  • II: osteoarthritis involving the whole radioscaphoid articulation
  • III: osteoarthritis of the radioscaphoid and capitolunate articulations
  • IV: osteoarthritis of the radiocarpal and intercarpal articulations +/- distal radioulnar joint (DRUJ)

In this case, it is a Stage III SLAC wrist.

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Case information

rID: 51849
Case created: 10th Mar 2017
Last edited: 28th Jun 2017
Inclusion in quiz mode: Included

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