Ultrasonography Detected Missed Lunate Volar Dislocation Associated With Median Neuropathy: A Case Report

Abstract

Lunate and perilunate dislocations are uncommon, but they have clinical importance because complications, such as median neuropathy and avascular necrosis of the lunate, can occur. Although early diagnosis enabling early surgical treatment is crucial for preventing long-term sequelae, these dislocations are frequently missed in the initial assessment. Imaging tools, such as plain radiography, magnetic resonance imaging, ultrasonography, and electrodiagnostic studies, have been used for diagnosis. The proper choice of initial evaluation tools is important for making an accurate early diagnosis. Here we present a case of lunate dislocation associated with median neuropathy in which ultrasonography, along with the electrodiagnostic study and plain radiography, played an important diagnostic role in detecting structural abnormalities. This case report reveals the complementary diagnostic role of ultrasonography in initial assessment and provides ultrasonographic images of lunate dislocation as a cause of median neuropathy.

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“…Most scientific papers consider idiopathic forms of CTS, and only some of them contain general information, without clinical features of the courses, on its secondary forms like posttraumatic and associated with an orthopedic pathology [5]. Despite long-term CTS studies, its diagnostics and treatment, the impact of different factors on the occurrence and progression of syndrome, the choice of treatment methods and their efficiency still cause acute discussions at dedicated European and International congresses [6,7]. Obviously, studying the secondary CTS's diagnostics and treatment, one should consider its etiological grounds and progression [8].…”