Wk 1, Case 5 - Review

Patient History
36-year-old male, evaluate for scapholunate ligament tear. Injury at work pulling himself up out of a 7-foot hole. Pain ulnar aspect getting worse.

Findings

ALIGNMENT:
Ulnar Variance: Neutral.

Distal Radioulnar Joint: Normal.

Carpal Instability: Stable.

ARTICULATIONS:
Thumb Carpometacarpal Joint: Normal.

Scaphotrapeziotrapezoidal Joint: Normal.

Pisiform-Triquetral Joint: Normal.

Carpal Effusion: Moderate.

Distal Radioulnar Joint Effusion: None.

INTRINSIC LIGAMENTS:
Scapholunate Ligament: Complete tear resulting in 7mm scapholunate diastasis.

Lunotriquetral Ligament: Intact.

Triangular Fibrocartilage: Intact.

Lunate Facet: Normal.

Hamate-Lunate Facet: Normal.

Extensor Compartment: No tendinopathy or tendon tears.

Flexor Compartment: No tendinopathy or tendon tears.

Carpal Tunnel: No space-occupying lesions.

Median Nerve: Normal size, diameter and signal intensity.

Flexor Retinaculum: No abnormal bowing or scarring.

Guyon's Canal: No space-occupying lesions.

OTHER FINDINGS:
Skeleton: No fracture or dislocations.

Soft Tissues: Multifocal, lobulated dorsal ganglion pseudocysts, largest in dorsal intercarpal region and measuring about 2.6cm x 1cm.

Vessels: Noncontributory.

Impressions
1. Complete tear of the scapholunate ligament with 7mm diastasis. No evidence of proximal capitate migration or scapholunate advanced collapse (SLAC).
2. Moderate intercarpal joint effusion.
3. Dorsal capsulosynovial/ganglion pseudocysts.