EURORAD ESR

Case 10858

Ulnar carpometacarpal dislocations, a complication to be reckoned

Author(s)
Sarti E, Rossi P, Tarantini G, Raffo L, Iodice V, Vitali S

Diagnostic and Interventional Radiology,
University of Pisa, Via Roma 67
56125 Pisa, Italy.
 
Patient
male, 39 year(s)
 
 
  • Figure 1
    X-ray findings
     

    Right forearm wrist and hand X-ray taken at the emergency department: displaced fractures of the central part of the ulna and proximal radius, with bone fragments

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Acute; Trauma;

    Right forearm wrist and hand X-ray taken at the emergency department: displaced fractures of the central part of the ulna and proximal radius, with bone fragments

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Acute; Trauma;
     
     
  • Figure 2
    X-ray (after surgery during immobilization) findings
     

    Forearm, wrist and hand X-ray two days after installation of two endomedullary Kirschner wires: wires are well placed, forearm is immobilized in a plaster.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Intraoperative; Special Focus: Acute; Trauma;

    Forearm, wrist and hand X-ray one month after surgery: Kirschner wires are well positioned, but there is still no bone callus

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Treatment effects; Special Focus: Trauma;

    Forearm, wrist and hand X-ray one month and twenty days after surgery: Kirschner wires are well positioned, bone callus is forming

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Treatment effects; Special Focus: Trauma;

    Lateral forearm, wrist and hand X-ray one month and twenty days after surgery: Kirschner wires are well positioned, bone callus is forming

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Treatment effects; Special Focus: Trauma;
     
     
  • Figure 3
    X-ray (after plaster removal) findings
     

    PA and lateral forearm and wrist X-ray images: Kirschner wires were removed and bone callus has formed

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Treatment effects; Special Focus: Trauma;

    Right wrist and hand X-ray: the AP view shows a subtle lateral displacement of long axis between F1 over 5th MTC bone.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: Conventional radiography; Procedure: Treatment effects; Special Focus: Trauma;
     
     
  • Figure 4
    CT findings
     

    CT axial images shows fracture margins of the ulna.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Treatment effects; Special Focus: Trauma;

    MPR coronal image: Irregular cortical bone due to severe chondropathy, detachment of a bone fragment under the base of the fourth metacarpal bone. Terry-Thomas sign is well recognized.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Trauma;

    Four sagittal MPR lateral-medial images of the dislocation of the base of the fourth metacarpal bone, in the third the detachment of a bone fragment appears

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Treatment effects; Special Focus: Trauma;

    Sagittal MIP image: view of the subluxation between the fourth metacarpal bone and the hamate bone

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Computer Applications-Detection, diagnosis; Computer Applications-General; Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 5
    3D volume rendering findings
     

    3d volume rendering of the right hand: the carpo-metacarpal joint of the fourth and fifth fingers is moved posteriorly compared to the others

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Trauma;

    3D volume rendering images that show dorsal view of the carpo-metacarpal joint with two different windows: dislocation of the fourth metacarpal bone and subluxation of the fifth

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Trauma;

    3D volume rendering image of the subluxation of the joint between fourth metacarpal bone and hamate bone

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Computer Applications-3D; Computer Applications-Virtual imaging; Diagnostic procedure; Special Focus: Trauma;
     
     
Right forearm wrist and hand X-ray taken at the emergency department: displaced fractures of the central part of the ulna and proximal radius, with bone fragments
 
Right forearm wrist and hand X-ray taken at the emergency department: displaced fractures of the central part of the ulna and proximal radius, with bone fragments
 
Forearm, wrist and hand X-ray two days after installation of two endomedullary Kirschner wires: wires are well placed, forearm is immobilized in a plaster.
 
Forearm, wrist and hand X-ray one month after surgery: Kirschner wires are well positioned, but there is still no bone callus
 
Forearm, wrist and hand X-ray one month and twenty days after surgery: Kirschner wires are well positioned, bone callus is forming
 
Lateral forearm, wrist and hand X-ray one month and twenty days after surgery: Kirschner wires are well positioned, bone callus is forming
 
PA and lateral forearm and wrist X-ray images: Kirschner wires were removed and bone callus has formed
 
Right wrist and hand X-ray: the AP view shows a subtle lateral displacement of long axis between F1 over 5th MTC bone.
 
CT axial images shows fracture margins of the ulna.
 
MPR coronal image: Irregular cortical bone due to severe chondropathy, detachment of a bone fragment under the base of the fourth metacarpal bone. Terry-Thomas sign is well recognized.
 
Four sagittal MPR lateral-medial images of the dislocation of the base of the fourth metacarpal bone, in the third the detachment of a bone fragment appears
 
Sagittal MIP image: view of the subluxation between the fourth metacarpal bone and the hamate bone
 
3d volume rendering of the right hand: the carpo-metacarpal joint of the fourth and fifth fingers is moved posteriorly compared to the others
 
3D volume rendering images that show dorsal view of the carpo-metacarpal joint with two different windows: dislocation of the fourth metacarpal bone and subluxation of the fifth
 
3D volume rendering image of the subluxation of the joint between fourth metacarpal bone and hamate bone
 
 
 
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