Right wrist/hand pain, decreased range of motion. Bone marrow signal intensity is normal. Note is made of congenital coalition of the lunate and triquetrum, a normal variant. There is perhaps mild synovitis dorsal to the proximal carpal row, but this is equivocal. The metacarpophalangeal joints appear normal. This study was not protocoled for detailed evaluation of the ligaments, but I see no gross abnormalities. Subjectively, there appears to be slight dorsal subluxation of the ulna relative to the sigmoid notch of the radius; however, using the modified radioulnar method of measurement as well as the epicenter method of measurement, distal radioulnar joint alignment is within normal limits. The visualized portions of the tendons of the hand and wrist appear normal. I see no definite abnormalities of the triangular fibrocartilage complex; apparent increase in signal intensity along the volar aspect of the volar radioulnar ligament likely simply represents interface with the ulnolunate and ulnotriquetral ligaments. The remaining soft tissue structures appear normal.
There is perhaps mild synovitis dorsal to the proximal carpal row, but I otherwise see no definite findings to account for the patient's pain. Although subjectively there appears to be slight dorsal subluxation of the distal ulna relative to the sigmoid notch of the radius, measurements do not support a true subluxation. If there is clinical concern for distal radioulnar joint instability then bilateral wrist CT with neutral, supination, and pronation positioning may be considered.