Disorder of ligament of the left wrist. Occult scaphoid fracture. Evaluation is limited by patient motion artifact.LIGAMENTS: Motion artifact limits evaluation of the intrinsic ligaments. There is increased signal intensity within the membranous portion of the scapholunate ligament seen on a single image (image 7; series 901) that could be artifactual in etiology or represent a focal perforation, but this is of questionable clinical significance. Given the limitations of a non arthrogram study, the lunotriquetral ligament appears intact.TRIANGULAR FIBROCARTILAGE COMPLEX: There is a large tear of the articular disc of the triangular fibrocartilage situated approximately 3 mm medial to its radial attachment.TENDONS: There is a small amount of fluid within the tendon sheath of the extensor pollicis longus tendon as it courses dorsal to the tendons of the second compartment. There is also a small amount of fluid within the sheath of the extensor carpi radialis brevis at the same location. This is nonspecific and could represent the sequela of recent trauma, although this can also be seen in patients with distal intersection syndrome. The remainder of the tendons appear intact.BONES: There is a comminuted intra-articular fracture of the distal radius with the fracture fragments in near-anatomic alignment and minimal if any step-off along the articular surface. There is also focal subchondral edema within the dorsal aspect of the distal ulna with a poorly defined linear focus of signal intensity that could represent a nondisplaced fracture, but the ulnar styloid itself appears intact. The carpal bones including the scaphoid are intact.ADDITIONAL
1. Comminuted intra-articular fracture of the distal radius with the fracture fragments in near-anatomic alignment. Focal and poorly-defined signal abnormality within the dorsal aspect of the distal ulna may represent a bone contusion or an additional nondisplaced fracture.2. Tear of the articular disc of the triangular fibrocartilage.3. Fluid within the sheaths of the extensor pollicis longus and extensor carpi radialis brevis tendons could represent distal intersection syndrome.These findings were relayed to Dr. Vitello by phone at 9:19 am on 3/8/16.