34-year-old female with pain. Evaluate for midcarpal instability. LIGAMENTS: Contrast is noted traversing the lunotriquetral ligament and the scapholunate ligament consistent with ligamentous disruption. TRIANGULAR FIBROCARTILAGE COMPLEX: The triangular fibrocartilage complex appears intact. No intra-articular contrast is identified within the distal radioulnar joint to suggest triangular fibrocartilage disruption.TENDONS: There is ulnar displacement of the extensor carpi ulnaris, which appears perched upon the ulnar styloid, suggestive of extensor carpi ulnaris subluxation, which can be seen in sub-sheath injury or rupture. BONES: There is increased bone marrow signal abnormality within the lunate bone which is nonspecific but may represent a bone contusion in the correct clinical setting although this may be inflammatory or degenerative in etiology. There is surgical resection of the triquetrum. Multiple foci of metallic susceptibility artifact in the overlying soft tissues are likely postsurgical in etiology. Additional metallic susceptibility artifact is identified within the first metacarpal also likely postsurgical in etiology. There is a slight dorsal tilt of the lunate bone.ADDITIONAL
1. Disruption of the scapholunate and lunotriquetral ligaments.2. Subluxation of the extensor carpi ulnaris suggesting sub-sheath injury or rupture, which may be chronic in etiology as there is no edema in the surrounding area, as described above.3. Findings suggestive of a synovitis consistent with the patients known inflammatory arthritis.4. Nonspecific edema within the lunate bone. Postsurgical changes and other findings, as described above.