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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]
Scaphoid fractures are often diagnosed using plain radiographs and multiple views are obtained as standard. [9] However, not all fractures are apparent initially. [7] In 1/4 of cases, the clinical examination suggests a fracture, but the X-ray does not show it, even though there is indeed a fracture. [10]
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.
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 ...
It is situated between the hand and forearm on the thumb side of the wrist (also called the lateral or radial side). It forms the radial border of the carpal tunnel. The scaphoid bone is the largest bone of the proximal row of wrist bones, its long axis being from above downward, lateralward, and forward.
X-ray of the affected wrist is required if a fracture is suspected. Posteroanterior, lateral, and oblique views can be used together to describe the fracture. [5] X-ray of the uninjured wrist should also be taken to determine if any normal anatomic variations exist before surgery. [5]
In apparently normal wrist radiographs from symptomatic patients, if there is history of a fall on an outstretched hand with pain in the anatomic snuffbox, suggesting scaphoid injury, the initial examination with posteroanterior, lateral, and pronation oblique views must be complemented by other specific views such as supination oblique and the ...