What's the most likely diagnosis?
- 23 year-old female with pain in both wrists
Frontal radiographs of each wrist
- Barton fractures
- Negative ulnar variance
- Madelung deformity
- Fong disease
- Scapho-lunate advanced collapse
Additional Image - Lateral radiographs of each wrist
Additional Images
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Lateral radiographs of each wrist
Answer:
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3. Madelung Deformity
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Madelung Deformity
General Considerations
- Arrest of epiphyseal growth of the ulnar (medial) and volar (anterior) portions of the distal radius
- Leads to shortening of the radius and relative overgrowth of the ulna
- Inherited as an autosomal dominant due to mutation on X chromosome and has variable penetrance
- Overwhelmingly occurs in females
- Rare congenital deformity that does not usually manifest until 10-14 years
- May also be seen as an acquired consequence of trauma to the growth plate (e.g. Salter V fracture)
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