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X-ray images indicate scapholunate ligament instability when the scapholunate distance is more than 3 mm, which is called scapholunate dissociation. [7] A static scapholunate 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 ...
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]
The main cause of DISI is [4] wrist trauma, with or without a fracture: Scaphoid fracture: bony DISI; Distal radius fracture: compensatory DISI; Malunion of radius fracture: adaptive DISI; Scapholunate ligament instability: ligamentous DISI
Scapholunate dissociation; Scapholunate ligament instability (rupture of this ligament leads to wrist instability) Triangular fibrocartilage complex (injury and degeneration) De Quervain tenosynovitis (when two tendons that control movement of the thumb become constricted by their tendinous sheath in the wrist)
The examiner will feel a significant 'clunk' and the patient will experience pain if the test is positive. For completeness, the test must be performed on both wrists for comparison. If the scapholunate ligament is disrupted, the scaphoid will subluxate over the dorsal lip of the distal radius. Original Description by Watson:
Dissociative disorder causes While strongly linked to a history of trauma, these disorders tend to travel with other psychiatric conditions such as post-traumatic stress disorder (PTSD) or ...
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Scapholunate advanced collapse is the most common form, followed by scaphoid non-union advanced collapse (SNAC). [3] Other post-traumatic causes such as intra-articular fractures of the distal radius or ulna can also lead to wrist osteoarthritis, but are less common.