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View Full Version : Lunate bone Problem, please help with diagnosis



disposition
11-05-2006, 02:38 PM
Hello, my name is ben and i have a problem with my wrist

my situation is this, about 18 months ago i was doing kung fu, and hurt my wrist when we were learning wrist locks etc. i was also doing punching bag work and other exercises where i sprained my wrist lightly(so i thought), anyway i thought it was just a sprain or something and would go away after some rest. well it basically did but there was always a weakness that remained there since, and soreness came in and out over the last 18 months. i never assumed that it was a ligament or anything, just that it took along time to heal and i kept annoying it through going to the gym and basketball etc.

so 3 weeks a go i decided to get it checked out by a physio after it became sore more than normal since i started to do work at TGI fridays, carrying plates and drinks and using my wrist in alot of different motions.

after two sessions, the physio said i should see the doctor because there was an instability in my right wrist, through diagnosis my wrist clunked and moved when force applied to it in a sidways motion(across the wrist, from what i can remember). after doing some research on the net into the wrist i can say that the only pay i feel is right in the middle of the wrist, above the area of the lunate bone, all the rest of the wrist is not painful including the scaphoid bone area so it is not that.

during the diagnosis with the physio(with the wrist instability tests) or in the days around that week period(maybe in my sleep) the lunate bone in the wrist seems to have been shifted upwards towards the top of my wrist, because when i bend my palm down towards the ground, the lunate bone sticks up and i can see it protruded, rather than on my other wrist it seems to be a smooth curve. this bone(which i think is the lunate) is located slightly off centre to the left of my right wrist.

so after getting xrays which showed nothing by the doctor, he said i should see a surgeon to work out what is my problem.

so i have a 6 week wait until then

bit worried that this bone is out of position and if time is important in fixing this?

could you please help me out with some sort of idea as to what is the reason for the lunate bone to be move out of position(or whole hand moved down from lunate) and if it is a ligament injury, does time matter as to the bone being out of place?

or will waiting 6 weeks be fine.

my wrist doesnt hurt that much apart from the area around the protruding bone, and i have limited movement.

another note is the bone only protrudes 3/4 of a centimetre out of the wrist compared to my left.

thankyou for your time

Ben

if you can reply through my email at incubus_dude@hotmail.com i check it many times a day

thankyou

injuryupdate
11-05-2006, 03:40 PM
Sounds like scapho-lunate ligament instability, but good to talk to your surgeon to check this.

Scott_1984
20-02-2007, 02:24 PM
Hiya,
Ben,
Sounds like you're suffering from: Mid Carpal Instability (MCI)/Palmar Midcarpal Instability (PMCI) Which is part of The Repetitive Strain Injury (RSI) Family, & Mid Carpal Instability (MCI)/Palmar Midcarpal Instability (PMCI) also known as:

Ulnar Midcarpal Instability,
CLIP-Wrist,
Wrist Instability,
Capitolunate Instability Patterns,
Capito Lunate Instability Pattern,
Ulnocarpal Instability,
Midcarpal Instability,
Mid Carpal Instability (MCI),
Palmar Midcarpal Instability (PMCI),
Wrist Pain,
Carpal Instability,
Inter-Carpal Instability,
Capitolunate Scaphoid Instability,

Your Probabaly need a Wrist Arthorscopy Operation for a Diagnosis, as most Ligament Damage will not show up on plan X-rays in the early stages of Carpal Instability or MRI-Scans, only after years will Carpal Instability show up on X-rays, unless under certain loads or stress tests.


http://uk.msnusers.com/PalmarMidcarpalInstabilityPMCIRSD/Documents/Carpal%20Instability%20%28Musculoskeletal%29.%2013-01-2006..pdf

http://uk.msnusers.com/PalmarMidcarpalInstabilityPMCIRSD/Documents/Understanding%20Mid%20Carpal%20Instability%20%28MC I%29-Palmar%20Midcarpal%20Instability%20%28PMCI%29%2020 06..pdf

http://groups.msn.com/PalmarMidcarpalInstabilityPMCIRSD/documents.msnw

Scott :¬)

Scott_1984
22-02-2007, 04:07 PM
Hiya,
Ben,
You are right to be reffered to an: Orthopaedic & Trauma Hand, Wrist, & Upper-Limb Consultant Surgeon.

Whom will be able to advice, treat, & diagnosis the correct wrist instability pattern/s.

I wouldn't wait 6 weeks, without going into a wrist splint with an Palmar metal plate, & still carrying out twice a day plus Physiotherpay Excerises that you've been showen by your Physiotherapist.

Also carry out RICE, while at the same time trying to use the hand/wrist to the best of your ability, without causing pain, discomfort, clunk/snap motions/movements.

Advoid an Clunking/Snapping Motion/Movements where humanly possible in every day to day normal day to day activities. (It's not always possible, with Wrist Instability sadly)

Take Care & Take It Easy :¬)

Scott :¬)

http://groups.msn.com/PalmarMidcarpalInstabilityPMCIRSD

http://uk.msnusers.com/PalmarMidcarpalInstabilityPMCIRSD/Documents/Carpal%20Instability%20%28Musculoskeletal%29.%2013-01-2006..pdf

http://uk.msnusers.com/PalmarMidcarpalInstabilityPMCIRSD/Documents/Understanding%20Mid%20Carpal%20Instability%20%28MC I%29-Palmar%20Midcarpal%20Instability%20%28PMCI%29%2020 06..pdf

jennie160
21-02-2008, 11:54 AM
I was wondering if you ever found anything out about your wrist problem. I recently fell and hurt my wrist. The doctor said it is just a sprain and did an x-ray to make sure it was not broken, which came out normal. But I have the same bump that you were referring to. Alittle off center in the back of my wrist when I bend it down, I believe it is the lunate as well.

Zaynah
28-02-2008, 12:09 AM
hi

A thing to remember is that lunate instability is usually because the scapholunate ligament get sprained. The bump that is usually felt is a cyst that develops out of this ligament, it is the prominent bump expecially when you bend you wrist, and is tender when you press on it. The joint may click and be painfull when you push it bakcwards hands flat as it compresses this cyst (ganglion) and the lunate isn't stable.

I had a chronic scapholunate ligament tear with a huge intra-osseous cyst that wrapped around my scaphoid. I had all the same symptoms with some thumb pain as the cyst grew into that area. I had the ligaments repaired and the cyst removed 2 and 1/2 months ago and the recovery is coming along slowely but surely.

A ultrasound or MRI will definately show the cyst and torn ligaments. Before this the specialist could order a clenched fist XRay where you make a tight fist while they take the Xray, as this will show a gap between the lunate and its surrounding bones if there is a instability.

Good luck.

wendyhoward
30-03-2008, 10:15 PM
Zaynah- do you still have this pain?

Zaynah
02-04-2008, 03:33 AM
hi ben

No.. I had surgery 3 and 1/2 months go... My thread is the "Dorsal wrist bump" section in the arms/hand injuries forum.

We couldn't find the cyst originally. everyone thought after the negative x-rays, that i might have an instability at the lunate-scaphoid area. i had lots of clicking with all the instability tests and even when i used the wrist writing or typing. my pain through palpation was exactly at the middle of the joint on the lunate bone (actually this is the scaphoid-lunate ligament where the cyst was) although i had no cyst protruding upwards, as my cyst grew across the joint like a mushroom and wrapped itself around my scaphoid bone. Only after the MRI scans, i got diagnosed with the huge cyst and a torn scapholunate ligament. They debrided the cyst and repaired the ligament by taking some of the ligement in the wrist that runs over the tendons of the hand (he cuts through this anyway to get to the bones)... and the sutured this ligament in place to repair the torn one. I had a plaster cast and Kwire pins to hold everything in place. I physio'd myself as i am one, and today i have full extension (backwards bending) and sideways movement. Bending the wrist forwards (mostly due to the scartissue) is stiff and i have 50degrees of flexion, so i need about 20degrees more, but i'll get there. No more pain or clicking. I work without hassels. I only refrain from putting my full body weight through my wrists, as this is not a good idea in the first place, so i avoid it, rather going onto my knuckles with a straight wrist, than bending the wrist backwards (like a pushup) if i need to take the weight. Put no problems. Getting the stiffness to go away is taking time and effort but i take everyday as i comes and everytime i measure the range of movement, i gain a few degrees. that gives me hope. i'll have the surgery again any day!

If X-rays are negative... suspect the cyst. sometimes with a clenched fist Xray they can see how much the bones move and then the measure the gaps of the joints... sometimes they miss the instability. Only MRI can show the cyst or torn ligaments.

Good luck.