Review Question - QID 8700

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Scapholunate Ligament Injury & DISI QID: 8700 (SAE07SM.38)

QID 8700 (Type "8700" in App Search)

A 28-year-old woman fell on her right wrist while rollerblading 6 days ago. She was seen in the emergency department at the time of injury and was told she had a sprain. Examination now reveals dorsal tenderness in the proximal wrist but no snuffbox or ulnar tenderness. Standard wrist radiographs are normal. What is the next most appropriate step in management?

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Arthroscopy of the wrist

15/1549

CT of the wrist

13%

197/1549

Bilateral PA clenched fist radiograph

75%

1168/1549

Electromyography and nerve conduction velocity studies

6/1549

AP and lateral radiographs of the forearm

10%

153/1549

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When considering the diagnosis of scapholunate ligament injury, standard radiographic views of the hand will not always reveal widening of the scapholunate gap. Although MRI may reveal injury to the ligaments, the PA clenched fist view can be obtained in the office during the initial patient visit. Arthroscopy is not a first-line diagnostic tool.

Current status of scapholunate interosseous ligament injuries.

John J Walsh,

Richard A Berger,

William P Cooney

Hand
- Scapholunate Ligament Injury & DISI

John J Walsh, JAAOS 2002

48 responses

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