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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The key investigation in Madelung's Deformity is radiography:

  • AP film:
    • shows defect at the location of the distal radial facet where the lunate sits
    • radial epiphysis on its ulnar side narrows to a point
    • may be spike of bone in the metaphysis
    • radius shorter and bowed compared to ulna
    • carpus seems to overlap distal radius and ulna as it is subluxed
    • in chevron carpus:
      • lunate pyramidal
      • scaphoid ring sign as it flexes forward
  • lateral:
    • bowing of radius
    • notch in distal radius, the position of which depends on the point of abnormal growth:
      • palmar in classical Madelung's deformity
      • dorsal in the less frequent reversed Madelung's deformity
      • central in chevron carpus
    • subluxation of carpus

MRI may help with the identification of soft tissue anomalies eg a thickened radiolunotriquetral ligament.


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