Musculoskeletal Imaging

Ulnar impaction syndrome

a degenerative disorder of the wrist resulting from excessive load bearing on the ulnar aspect, almost always associated with a positive ulnar variance. Patients experience ulnar-sided wrist pain, swelling, and limitation of motion. With chronic impaction of the ulnar head against the triangular fibrocartilage complex TFCC , progressive deterioration of the triangular fibrocartilage complex, chondromalacia of the lunate and head of the ulna, and attrition of the lunotriquetral interosseous ligament occur.

On routine radiographs, alterations in the lunate, triquetrum and ulnar head are observed (Fig.1). Bone sclerosis, cysts and osteophytes are characteristic. Arthrography and MR imaging often reveal communicating defects of the triangular fibrocartilage and disruption of the lunotriquetral interosseous ligament.

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Fig.1

Oblique radiograph of the wrist demonstrates close apposition between the distal ulna and adjacent lunate bone.
Ulnar impaction syndrome, Fig.1