Presentation
Wrist pain. No trauma.
Patient Data
(Scapholunate dissociation) Scapholunate increased distance (8mm) between the scaphoid and the lunate bones (Therry Thomas sign) (Normal distance < 4 mm).
Dorsally tilted lunate axis with increased scapholunate angle and capitolunate angles measuring 86°& 44°, (Normal <45° & < 30°)
Those findings are compatible with Dorsal intercalated segment instability (DISI).
(Scapholunate dissociation) Scapholunate ligament tear resulting in increased distance (8mm) between the scaphoid and the lunate bones (Therry Thomas sign) (Normal distance < 4 mm). Proximal migration of the capitate bone.
Dorsally tilted lunate axis with increased scapholunate angle and capitolunate angles measuring 86°& 44°, (Normal <45° & < 30°)
Those findings are compatible with Dorsal intercalated segment instability (DISI).
Mild degenerative changes of the intercarpal joints evident by narrowing of the joint spaces, subchondral marrow degenerative changes involving the carpal bone.
Those findings are impressive of Scapholunate advanced collapse (SLAC) (Stage IV)
Case Discussion
SLAC (scapholunate advanced collapse) is often a consequence of untreated chronic scapholunate dissociation or from chronic scaphoid non-union resulting in subluxation and a specific pattern of osteoarthritis.
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