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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]
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 ...
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 ...
If the scapholunate ligament is disrupted, the scaphoid will subluxate over the dorsal lip of the distal radius. Original Description by Watson: "The patient is approached by the examiner as if to engage in arm wrestling, face to face across a table with diagonally opposed hands raised (right to right or left to left) and elbows resting on the ...
The physical exam may show tenderness by palpation over the scapholunate ligament on the back of the wrist, immediately below the radius. [1] [4] Swelling and deformities are the two clinical signs associated with arthritis. The wrist is clinically tested by slight flexion while the physician feels the back of the wrist with the thumb. [4]
Wrist osteoarthritis is gradual loss of articular cartilage and hypertrophic bone changes (osteophytes). While in many joints this is part of normal aging (senescence), in the wrist osteoarthritis usually occurs over years to decades after scapholunate interosseous ligament rupture or an unhealed fracture of the scaphoid.
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
Instability in the wrist can be caused by a torn Scapholunate ligament. The Brunelli Procedure does not fix the torn ligament. A hole is drilled through the Scaphoid bone and a part of a tendon taken from the patient is put through this hole and attached to the nearby bones. The procedure usually results in reduced movement of the wrist.