[Madelung deformity due to abnormal radiolunate ligament: report of 4 cases].
OBJECTIVE
To define the value of CT and MR in the demonstration of an abnormal radiolunate ligament contributing to a Madelung deformity and emphasize the features on wrist radiographs suggesting the presence of such ligament.


RESULTS
Four cases of adolescents presenting with uni- or bilateral wrist pain are reviewed. Standard radiographs demonstrated the present of isolated Madelung deformity with increased inferior radioulnar curvature with triangularization of epiphyses and decreased carpal angle. Each patient underwent either noncontrast CT, CT arthrography or MRI. All cross-sectional imaging studies demonstrated the presence of an abnormal radiolunate ligament with radial insertion within a bony gutter. Retrospectively, the bony gutter could be identified on radiographs. In two cases, excision of the ligament provided partial correction of the deformity and symptoms, without need for classical osteotomy.


CONCLUSIONS
In patients with Madelung deformity, CT or better yet non-ionizing and noncontrast MR may demonstrate a abnormal radiolunate ligament within a bony gutter. Detection of this gutter on radiographs suggests the presence an abnormal ligament. Early release of the abnormal ligament appears to decrease wrist deformity, improve range of motion and reduce symptoms.
de Brito
P
P
Service de Radiopédiatrie, Hôpital Clocheville, CHRU Tours, 49 boulevard Béranger, Tours Cedex 9. philippedebrito@hotmail.fr
Metais
J P
JP
Guilley
C
C
Goguey
B
B
de Courtivron
B
B
Sirinelli
D
D
D000293:Adolescent; D019412:Anatomy, Cross-Sectional; D001175:Arthrography; D002648:Child; D004838:Epiphyses / Q000002:abnormalities; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000002:abnormalities*; D012667:Lunate Bone / Q000002:abnormalities*; D008279:Magnetic Resonance Imaging; D011884:Radius / Q000002:abnormalities*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology