FINDINGS:
Marker was placed along the dorsal aspect of the mid carpus.
Status post distal radioulnar arthrodesis with complete osseous fusion across the joint, and resection of the distal ulnar metaphysis (Suave Kapandji procedure). T2 hyperintensity and susceptibility distal ulna related to surgical material.
Complete four-corner osseous fusion of the lunate, triquetrum, capitate and hamate.
Extensive degeneration of the radioulnar carpal joint with severe loss of joint space, bone-on-bone articulation, grade 4 cartilage defects, and subchondral cysts and edema
Fluid:
Carpus effusion: Small effusion. Multiple small synovial cysts and ganglia. Synovial thickening: Moderate. Intra-articular body: Small.
Intrinsic ligaments:
Scapholunate: Torn volar band. Partial tears of the membranous and dorsal portions.
Lunotriquetral: Ossified.
Ulnar side:
Triangular fibrocartilage ligament: Not visualized, chronically macerated.
Lunate facet: Fused with the capitate and hamate.
Hamate-lunate: Fused.
Ulnocarpal impaction: Present with subchondral cyst and edema in lunate and triquetrum.
Extensor compartment:
I: Mild tendinopathy of APL.
II: Trace fluid.
III: Normal.
IV: Normal.
V: Normal.
VI: Chronically dislocated.
Flexor compartment:
Flexor retinaculum: Intact.
Common flexor tendons: Normal.
Flexor policis longus tendon: Normal
Flexor carpi radialis longus tendon: Normal
Carpal tunnel: Normal.
Median nerve: Normal.
Guyon canal: Normal.
Articular:
Thumb carpometacarpal / Metacarpophalangeal joints: Mild to moderate osteoarthrosis.
Lesser carpometacarpal joints: Moderate osteoarthrosis.
Scaphotrapeziotrapezoidal joint: Moderate osteoarthrosis.
Pisiform-triquetral joint: Small effusion.
Extrinsic ligaments:
Radial collateral ligament: Attenuated.
Ulnar collateral ligament: Chronic.tear.
Dorsal intercarpal ligament: Synovitis adjacent to the ulnar aspect.
Volar extrinsic ligament: Intact.
Bones: Otherwise normal.
Muscles: Normal.
Vessels: Normal.
Other: Ulnar-sided dorsal soft tissue edema, most prominently at the level of the skin marker. Suture anchor at the dorsal wrist capsule at the level of the ulnocarpal joint
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Office: 214-648-2122
avneesh.chhabra
