Case of the Week

History: 36 year old female with left wrist pain.

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Answer:
Madelung Deformity – premature arrest of the epiphyseal growth of the ulnar and volar portions of the distal radius. Inherited autosomal dominant X mutation; F>M. It usually manifests in the second decade. This condition usually presents as wrist pain. Other clinical signs are prominent posterior distal ulnar head and limited wrist extension and supination. Findings on imaging include “V-shaped” proximal carpal row, dorsal dislocation of the ulnar head, and exaggerated radial inclination. The deformity is bilateral in 50-66% of patients. Treatment is conservative unless patient is symptomatic in which case surgical correction is an option.

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