In radiology, the Terry Thomas sign is a scapholunate ligament dissociation on an anteroposterior view of the wrist. Most commonly a result of a fall on the outstretched hand (), the scapholunate ligament ruptures resulting in separation of the lunate and scaphoid bones.This burst causes the scaphoid bone to dorsally rotate. A gap of more than 3mm is pathognomonic for scapholunate dissociation.
ER assessment of wrist pain scapholunate dislocation
A static instability is generally readily visible, but a dynamic scapholunate instability can only be seen radiographically in certain wrist positions or under certain loading conditions, such as when clenching the wrist, or loading the wrist in ulnar European Journal of Radiology, Volume 92 p. 45- 50 Scapholunate dissociation (SLD) is a form of carpal instability, caused by rupture of the scapholunate ligament (SLL) the secondary stabiliser of the scapholunate (SL) compartment. The treatment of scapholunate dissociation remains controversial. Although good to excellent results have been reported using a variety of surgical techniques, they have often not been confirmed by other authors. Limited wrist mobility and the likelihood that degenerative changes will progress appea … 10.1055/b-0034-77597 10 Carpal LigamentsSchmitt, R. The carpal ligaments guarantee stability of the carpal joints while allowing considerable freedom of movement in these joints of complex construction.
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Scapholunate (SL) instability is the most common dissociative carpal instability condition. It is the most frequent cause of wrist osteoarthritis, defined as scapholunate advanced collapse or SLAC wrist. Familiarity with the SL ligament complex is required to understand the various features of SL in … The dorsal scapholunate ligament is completely or partially visible in 78% of normal wrists. Its detection following injury may help to exclude the possibility of scapholunate dissociation. There is a quite wide variation in scapholunate interval widths on sonography and an unpredictable response with stress testing.
A scapholunate dissociation (SLD), which progresses through several stages, finally ends as a perilunate dislocation. The injury can be completely ligamentous or can be a combined fracture and ligamentous injury. SLD is one of the most common types of carpal instability. Often overlooked, it may lead to weakness and arthritis.
Most commonly a result of a fall on the Imaging tests such as X-ray, MRI or CT-scan may be ordered. Diagnosis is confirmed through evidence of the following: Instability of the ligaments supporting the 1 Oct 2008 Discuss the significance of carpal injuries and the role of imaging in of the tuberosity and avulsion of the proximal pole by a scapholunate ligament. A sign of an early stage of perilunate dislocation may be wideni Thirty-two consecutive patients who had routine x-ray films were examined 12 days after wrist injury because of persistent signs and symptoms of wrist scapholunate ligament, scapholunate dissociation, combined radius-wrist than really diagnosed by means of clinical and radiologic signs [8,9].
6 Aug 2018 SLL injuries resulting in scapholunate dissociation are thought to Another radiologic finding, the “scaphoid ring sign”, can sometimes be seen
Saved by Se hela listan på physio-pedia.com scapholunate dissociation caused by gouty arthritis of the wrist: case report 8 July 2009 | Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, Vol. 34, No. 2 X-Ray Characteristics of Wrists in Calcium Pyrophosphate Crystal Deposition Disease 2017-07-01 · Scapholunate ligament (SLL) tears are a common type of wrist ligament injury , , , . Tearing of this ligament can lead to abnormal alignment and kinematics of the wrist, also known as a scapholunate dissociation (SLD). Radiological evaluation of scapholunate intercarpal ligamentoplasty for chronic scapholunate dissociation in cadavers. Athlani L(1), Pauchard N(1), Dautel G(1). Author information: (1)Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé CHU de Nancy, Nancy, France. Pioneer in Rad Blogging. First mover in Radiology & Web 2.0.
2018 Mar;48(3):225 Pliefke J, Stengel D, Rademacher G, Mutze S, Ekkernkamp A, Eisenschenk A. Diagnostic accuracy of plain radiographs and cineradiography in diagnosing traumatic scapholunate dissociation.
Its features, however, also have been observed in patients with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. European Journal of Radiology, Volume 92 p. 45- 50 Scapholunate dissociation (SLD) is a form of carpal instability, caused by rupture of the scapholunate ligament (SLL) the secondary stabiliser of the scapholunate (SL) compartment. Measurement of the scapholunate distance is used as one of the indicators for carpal instability.
The Terry Thomas (or Madonna) sign is given to the increase in the scapholunate space identified on an AP radiograph. The increased distance indicates scapholunate dissociation. 3 article feature images from this case 16 public playlist includes this case
Scapholunate dissociation (SLD) represents first stage in spectrum of perilunate dislocations described by Mayfield et al Rupture of the SLIL leads to varying degrees of Volar flexion, ulnar deviation, and pronation of the scaphoid Extension, supination, and radial deviation of the lunate and triquetrum
Scapholunate advanced collapse (SLAC), commonly known as SLAC wrist, refers to a pattern of wrist malalignment that has been attributed to post-traumatic or spontaneous osteoarthritis of the wrist.
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Xray indicates scapholunate ligament instability when the scapholunate distance is more than 3 mm, which is called scapholunate dissociation. A static instability is generally readily visible, but a dynamic scapholunate instability can only be seen radiographically in certain wrist positions or under certain loading conditions, such as when clenching the wrist, or loading the wrist in ulnar
doi:10.2519/jospt.2018.7774. PMID: A: Widening of the scapholunate space signifying scapholunate dissociation otherwise known as the 'Terry Thomas' sign.
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Scapholunate dissociation | Radiology Case | Radiopaedia.org. This represents a surgically significant ligamentous injury. Saved by Se hela listan på physio-pedia.com scapholunate dissociation caused by gouty arthritis of the wrist: case report 8 July 2009 | Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, Vol. 34, No. 2 X-Ray Characteristics of Wrists in Calcium Pyrophosphate Crystal Deposition Disease 2017-07-01 · Scapholunate ligament (SLL) tears are a common type of wrist ligament injury , , , .
Scaphoid Cortical Ring Sign. When there is rotation of the scaphoid as can occur with scapholunate dissociation (widening of distance between scaphoid and lunate to greater than 3 mm), (yellow arrow), a ring-shaped density can appear as a sign of foreshortening (white arrow).
DISI (dorsal intercalated segmental instability) scapholunate dissociation causes the scaphoid to flex palmar and the lunate to dorsiflex; if left untreated the DISI deformity can progress into a SLAC wrist Townsville radiology training.
Radiology. 2000 Sep;216(3):846-50. 5 Elsaidi GA, Ruch DS, Kuzma GR, and Smith BP. Dorsal wrist ligament insertions stabilize the scapholunate interval: cadaver study.