Case Of the Week (COW) 07 Sep 2014
Answer:
Ulnar impaction syndrome.
Findings:
XRAY – Neutral Variance with long ulnar styloid.
MRI - Central perforation of the TFCC.Hyperintensity of meniscal homologue.Subchondral cysts and marrow edema in the lunate and triquetral bones.Chondromalacia of the ulnar styloid and radial side of the triquetral bone.
Discussion:
Ulnar impaction syndrome is also called ulnar abutment or ulnocarpal loading. Degenerative condition characterized by ulnar wrist pain, swelling, and limitation of motion causing excessive load bearing across the ulnar aspect of the wrist.Chronic impaction between the ulnar head and the TFC complex and ulnar carpus results in a continuum of pathologic changes. Degenerative tear of the TFC chondromalacia of the lunate bone, triquetral bone, and distal ulnar head Instability or tear of the lunotriquetral ligament Osteoarthritis of the ulnocarpal and distal radioulnar joints. Secondary changes in the ulnar carpus include subchondral sclerosis and cystic changes in the ulnar head, ulnar aspect of the proximal lunate bone, and proximal radial aspect of triquetral bone.
Contributed By:
Dr. Balaji Ayyamperumal
Tanjore Medical College
Answer:
Ulnar impaction syndrome.
Findings:
XRAY – Neutral Variance with long ulnar styloid.
MRI - Central perforation of the TFCC.Hyperintensity of meniscal homologue.Subchondral cysts and marrow edema in the lunate and triquetral bones.Chondromalacia of the ulnar styloid and radial side of the triquetral bone.
Discussion:
Ulnar impaction syndrome is also called ulnar abutment or ulnocarpal loading. Degenerative condition characterized by ulnar wrist pain, swelling, and limitation of motion causing excessive load bearing across the ulnar aspect of the wrist.Chronic impaction between the ulnar head and the TFC complex and ulnar carpus results in a continuum of pathologic changes. Degenerative tear of the TFC chondromalacia of the lunate bone, triquetral bone, and distal ulnar head Instability or tear of the lunotriquetral ligament Osteoarthritis of the ulnocarpal and distal radioulnar joints. Secondary changes in the ulnar carpus include subchondral sclerosis and cystic changes in the ulnar head, ulnar aspect of the proximal lunate bone, and proximal radial aspect of triquetral bone.
Contributed By:
Dr. Balaji Ayyamperumal
Tanjore Medical College