Madelung deformity with Vicker Ligament and anomalous Radiotriquetral ligament

contributed by: Teleradiologyhub
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Findings
o Volar tilt, shortening of articular surface and absent sigmoid notch of the distal radius with increased ulnar angulation, due to a deceleration of growth in the ulnar portion of the distal epiphysis.
o Elongated & dorsally subluxated ulna.
o The lunate is dropped between the radius and ulna with triangulation (pyramidal configuration) of the proximal carpal row.
o Prominent short radiolunate ligament (Vickers ligament) that originates from the ulnar border of the radius, inserts into the volar pole of the lunate - likely contributes to carpal pyramidalization.
o Anomalous hypertrophied and elongated volar radiotriquetral ligament.
Above findings are suggestive of Madelung deformity.
o Partial disruption of the TFCC.
o PDFS hyperintense marrow edema at dorsal aspect of ulnar end with mild edema in surrounding soft tissues.
Diagnosis
• Madelung deformity.
• TFCC partial disruption with marrow edema in distal ulnar end – represents sequalae of Ulnar volar subluxation.
Teleradiologyhub FRCR , MD , DNB , MNAMS is a Assistant Professor from Mumbai with experience of 11-15 years post-graduated from Tata Hospital, Parel. Specialized in Reporting of CT-SCAN , MRI cases with expertise in Neuro-imaging , Spine-imaging , Musculoskeletal , Stroke-imaging
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