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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 ...
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.
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 ]
The capitate is the largest carpal bone found within the hand. [2] The capitate is found within the distal row of carpal bones. The capitate lies directly adjacent to the metacarpal of the ring finger on its distal surface, has the hamate on its ulnar surface and trapezoid on its radial surface, and abuts the lunate and scaphoid proximally.
[1]: 6 It, along with the lunate bone, articulates with the radius and ulna to form the major bones involved in movement of the wrist. [5] The scaphoid serves as a link between the two rows of carpal bones. With wrist movement, the scaphoid may flex from its position in the same plane as the forearm to perpendicular. [1]: 176–177
Preiser disease, or avascular necrosis of the scaphoid, is a rare condition where ischemia and necrosis of the scaphoid bone occurs without previous fracture.It is thought to be caused by repetitive microtrauma or side effects of drugs (e.g., steroids or chemotherapy) in conjunction with existing defective vascular supply to the proximal pole of the scaphoid.