Patient History
55-year-old female who injured wrist on the countertop in 2016.
Findings
ALIGNMENT:
Ulnar Variance: Normal.
Distal Radioulnar Joint: Normal.
Carpal Instability: Normal.
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: Small central perforation of the disc proper. High-grade sprain of the proximal and distal veins of the triangular ligament attachments within ulnar fovea and styloid, respectively.
Lunate Facet: Normal.
Hamate-Lunate Facet: Oblique, nondisplaced, incomplete fracture coursing through dorsal, ulnar aspect of the triquetrum. The hamate lunate facet is intact.
Extensor Compartment:
I: Normal.
II: Normal.
III: Normal.
IV: Normal.
V: Normal.
VI: Subluxation of the extensor carpi ulnaris perched on the ulnar styloid consistent with stripping of the extensor carpi ulnaris subsheath.
Flexor Compartment: Normal.
Carpal Tunnel: No space-occupying lesions.
Median Nerve: Normal.
Flexor Retinaculum:
Flexor Tendons: Normal.
Guyon's Canal: Normal.
OTHER FINDINGS:
Skeleton: Oblique, nondisplaced incomplete fracture coursing through the dorsal ulnar aspect of the triquetrum. Focal nondisplaced avulsion fracture of the ulnar styloid with osteoedema.
Soft Tissues: Confluent soft tissue swelling along the extensor retinaculum region. Vessels: Normal.
Impressions
1. Oblique nondisplaced fracture through the dorsal ulnar aspect of the triquetrum.
2. Nondisplaced avulsion fracture of the ulnar styloid.
3. Subluxation of the extensor carpi ulnaris.
4. Focal tiny perforation of the TFCC disc proper. High-grade sprain of the proximal and distal veins of the TFCC triangular ligament in keeping with a Palmer 1B lesion.
