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.
