Your ultimate resource for Musculoskeletal teaching files and Musculoskeletal imaging & case of the day. Improve your diagnostic imaging skills online.

Case A:

30 year old male, wrist pain
Findings? Dx?
MRI Correlation
Final Dx?
Thumbnail imageThumbnail image
Case B:
29 year old Female, wrist pain

Findings, Dx?
Thumbnail imageThumbnail image
Case C:
28 year old male, wrist pain
Findings, Dx?

Thumbnail imageThumbnail image
Case D:
27 year old Female, wrist pain

Findings, Dx?
Thumbnail imageThumbnail image
Carpal Dislocations
Thumbnail imageThumbnail image
Cases 7A-D show the spectrum of lesser-arc injuries:

7A / Grade 1: Scapholunate dissociation ( = rotatory subluxation)
7B / Grade 2: Perilunate dislocation
7C / Grade 3: Midcarpal Dislocation (disruption of lunate/triquetrum)
7D / Grade 4: Lunate dislocation
Typical mechanism is severe dorsiflexion (e.g., fall on outstretched hand)

27A – Scapholunate Dissociation
Thumbnail imageThumbnail image
  • Initial case (7A) showed only widening (> 2mm) between the scaphoid and the lunate; this is the “Terry Thomas” (aka “David Letterman”) sign
  • The lateral film is not especially helpful for diagnosing this injury
  • These findings represent scapholunate dissociation (rotatory subluxation of the scaphoid), and is the mildest form of this injury
Case B-D
Thumbnail imageThumbnail image
Thumbnail imageThumbnail image

Case 7B showed a transcaphoid perilunate dislocation; note that the lunate and radius remain normally aligned. This injury is 2-3x more common than a lunate dislocation
  • accompanied by a scaphoid fracture in 75%
Midcarpal and lunate dislocations, as shown in cases 7C and 7D, represent progressively more severe injuries
  • key to diagnosis is the lunate position on the lateral films
These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.

Warning: include(/home/hihadmin/public_html/includes/wrapper.php) [function.include]: failed to open stream: No such file or directory in /home/hihadmin/public_html/templates/ja_teline_iii/layouts/default.php on line 133

Warning: include() [function.include]: Failed opening '/home/hihadmin/public_html/includes/wrapper.php' for inclusion (include_path='.:/opt/php53/lib/php') in /home/hihadmin/public_html/templates/ja_teline_iii/layouts/default.php on line 133