Wk 5, Case 1 - Supplemental Case

Patient History
35-year-old female with forearm discomfort and wrist pain

Findings

ALIGNMENT:

Ulnar Variance: Neutral.

Distal Radioulnar Joint: Normal alignment.

Carpal Instability: None.

ARTICULATIONS:

Thumb Carpometacarpal Joint: Normal.

Scaphotrapeziotrapezoidal Joint: Normal.

Pisiform-Triquetral Joint: Normal.

Radiocarpal Joint: Normal.

Distal Radioulnar Joint: Low-grade strain of the dorsal radioulnar ligament.

Fluid: A small 1.1cm ganglion pseudocyst at the volar aspect of the capitatohamate joint.

Carpal Effusion: None.

Distal Radioulnar Joint Effusion: None.

INTRINSIC LIGAMENTS:

Scapholunate Ligament: Intact.

Lunotriquetral Ligament: Intact.

Triangular Fibrocartilage: High-grade strain or avulsion of the proximal and distal lamina also known as the foveal and styloid attachments, respectively of the triangular ligament of the triangular fibrocartilage complex with edema throughout the meniscus homologous and ulnar collateral ligament.

TFC disc proper is intact.

Lunate Facet: Normal.

Hamate-Lunate Facet: Normal.

Extensor Compartment: No evidence of tendinosis, tenosynovitis or tendon tears.

Flexor Compartment: No evidence of tendinosis, tenosynovitis or tendon tears.

Carpal Tunnel: No space-occupying lesions

Median Nerve: Normal.

Flexor Retinaculum: No thickening or volar bowing.

Flexor Tendons: Normal.

Guyon's Canal: Normal.

OTHER FINDINGS:

Skeleton: No fracture or dislocations.

Soft Tissues: No space-occupying masses.

Vessels: Normal neurovascular bundle.

Impressions
1.Avulsion and high-grade strain of the foveal and ulnar attachments, respectively of the proximal and distal band of the triangular ligament with diffuse edema throughout the meniscus homologous in keeping with a Palmer type 1B injury of the TFCC.
2.Low-grade strain of the dorsal radioulnar ligament.