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In radiology, the Terry-Thomas sign is a scapholunate ligament dissociation on an anteroposterior view of the wrist. [1] [2] 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. [3]
To perform the test, the examiner grasps the wrist with their thumb over the scaphoid tubercle (volar aspect of the palm) in order to prevent the scaphoid from moving into its more vertically oriented position in ulnar deviation. For the test, the wrist needs to be in slight extension. The patient's wrist is then moved from ulnar to radial ...
A scaphoid fracture is a break of the scaphoid bone in the wrist. [1] Symptoms generally includes pain at the base of the thumb which is worse with use of the hand. [ 2 ] The anatomic snuffbox is generally tender and swelling may occur. [ 2 ]
When the X-ray is diagnostic and there is a convincing Terry Thomas sign it is a static scaphoid instability. When the scaphoid is made unstable by either the patient or by manipulation by the examining physician it is a dynamic instability. [11] SNAC. In order to diagnose a SNAC wrist you need a PA view X-ray and a lateral view X-ray.
The scapholunate ligament is an intraarticular ligament binding the scaphoid and lunate bones of the wrist together. It is divided into three areas, dorsal, proximal and palmar, with the dorsal segment being the strongest part. [3] It is the main stabilizer of the scaphoid. In contrast to the scapholunate ligament, the lunotriquetral ligament ...
The radius and scaphoid articulate deep to the snuffbox to form the basis of the wrist joint. In the event of a fall onto an outstretched hand (FOOSH), this is the area through which the brunt of the force will focus. This results in these two bones being the most often fractured of the wrist.
The PA wrist x-ray will demonstrate sclerosis and joint space narrowing between the lunate and capitate. Over time, the capitate will migrate proximally into the space created by the scapholunate dissociation. [2] The radiographic findings in Stage III SLAC wrist are synonymous with the Terry-Thomas sign, indicating complete scapholunate ...
running along the proximal convexity of the scaphoid, lunate and triquetrum: Second arc running along the distal concavities of the scaphoid, lunate and triquetrum: Third arc running along the proximal curvatures of the capitate and hamate