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Its position is the intersections of the long axes of the four fingers while in a fist, or the base of the thenar eminence. When palpated in this position, the bone will be felt to slide forward during radial deviation (wrist abduction) and flexion. Clicking of the scaphoid or no anterior translation can indicate scapholunate instability.
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]
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]
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.
In the event of inordinate application of force over the wrist, this small scaphoid is likely to be the weak link [citation needed]. Scaphoid fracture is one of the most frequent causes of medico-legal issues. An anatomical anomaly in the vascular supply to the scaphoid is the area to which the blood supply is first delivered.
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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 ...