Wk 2, Case 3 - Review

Patient History
23-year-old male with hyperextended wrist presenting with weakness and diminished grasp.

Findings

ALIGNMENT:

Ulnar Variance: Normal.

Distal Radioulnar Joint: Normal.

Carpal Instability: Intact.

ARTICULATIONS:

Thumb Carpometacarpal Joint: Normal.

Scaphotrapeziotrapezoidal Joint: Normal.

Pisiform-Triquetral Joint: Normal.

Radiocarpal Joint: Normal.

Distal Radioulnar Joint: Normal.

Fluid: None.

Carpal Effusion: None.

Distal Radioulnar Joint Effusion: None.

INTRINSIC LIGAMENTS:

Scapholunate Ligament: Intact.

Lunotriquetral Ligament: Intact.

Triangular Fibrocartilage: Intact.

Lunate Facet: Normal.

Hamate-Lunate Facet: Normal.

Extensor Compartment: Swelling of the 2nd compartment, with fluid extension of the extensor carpi radialis longus tendon sheath and swelling at the attachment of the extensor carpi radialis brevis.

Flexor Compartment: Normal.

Carpal Tunnel: No space-occupying lesions.

Median Nerve: Normal diameter and signal intensity.

Flexor Retinaculum: No thickening or palmar bowing.

Flexor Tendons: Intact.

Guyon's Canal: No space-occupying lesions.

OTHER FINDINGS:

Skeleton: Contusion or microtrabecular fractures involving the bases of the 2nd and 3rd metacarpals.

Subcentimeter intercapitate intraosseous ganglion.

Soft Tissues: Severe dorsal soft tissue swelling involving the intercarpal ligament and the dorsal radiotriquetral ligament.

Vessels: Normal.

Impressions
1.Dorsal capsular wrist injury involving the extrinsic dorsal capsular ligaments, mainly the dorsal intercarpal (DIC) and dorsal radiotriquetral ligaments.
2.Swollen 2nd and 3rd extensor compartments.
3.Contusion or microtrabecular fractures at the 2nd and 3rd metacarpal bases. Further correlation with CT to exclude chip injuries recommended.