20241205 Wist disorder p4 Dr Manoosh

Which of the following imaging features are not suggestive of Ulna Abutment Syndrome?

• A. Positive Ulna Variance in wrist xray

• B. Subchondral sclerosis over radial aspect of lunate

• C. Chondromalacia of distal ulna cartilage

• D. Bone edema in T2-weighted images

• E . Lunatotriquetral ligament tear in T2-weighted image

An ulnar shortening osteotomy would be MOST indicated for which of the following patients presenting with longstanding ulnar sided wrist pain refractory to conservative measures?

• A. 34-year-old female with an ulnar neutral wrist and distal radioulnar joint incongruity

• B. 34-year-old female with an ulnar positive wrist and distal radioulnar joint incongruity

• C. 34-year-old female with an ulnar negative wrist and distal radioulnar joint incongruity

• D. 78-year-old female with ulnar positive wrist and distal radioulnar joint arthritis

• E. 78-year-old female with ulnar negative wrist and distal radioulnar joint arthritis

32 years old male, working as labourer, and left hand dominant, presented with 6 months history of left wrist pain which aggravated upon lifting heavy loads at work. Examination revealed reduced grip strength with limited wrist flexion and extension. Based on the X-ray shown, what will be the best choice of treatment at this moment?

• A. Splint + NSAIDs

• B. Ulna shortening osteotomy

• C. Transfer of vascularized pisiform bone graft

• D. Proximal Row Carpectomy

• E. Wafer Procedure

All of the following are possible causes of Kienbock’s Disease except

• A. Reduced radial inclination

• B. I-shaped intraosseous blood supply of lunate

• C. Single distal articular facet (Type I)

• D. Negative Ulna Variance

• E. Radial shortening due to malunion

An unemployed 60-year-old female, has 3 years of increasing wrist pain. She was seen by a hand surgeon and diagnosed her with Kienbock disease. Her radiographs are shown in Figures A and B. Based on the radiographs, the patient’s lunate pathology is at what stage?

• A. Stage I - lunate edema

• B. Stage II - lunate sclerosis

• C. Stage IIIa - lunate collapse

• D. Stage IIIb - lunate collapse with scaphoid flexion

• E. Stage IV - lunate collapse with pancarpal arthritis