Scapholunate dissociation

Case contributed by Sakher Alkhaderi
Diagnosis certain

Presentation

Pain and swelling of the wrist following a fall on an outstretched hand

Patient Data

Age: 35 years
Gender: Male
mri

There is widening of the scapholunate interval greater than 4 mm (known as the Terry Thomas sign) with ill-defined signal changes in the scapholunate space consistent with rupture of the scapholunate ligament. There is a small ganglion cyst in the ulnar aspect of the wrist joint.   

Case Discussion

Scapholunate dissociation represents a significant ligamentous injury that is important to identify on imaging. There is disruption of the scapholunate ligament with resultant instability. Presentation is often delayed in the absence of associated fracture, pain is increased by dorsiflexion. 

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