Andrew E. Caputo and H. Kirk Watson
A 62-year-old right hand dominant woman who works as a polisher presented with right wrist pain progressively worsening over the last 6 months. She noted significant and progressive difficulty with strength and holding onto small objects. She denied any trauma and noted no specific previous treatment.
The patient had specific localized tenderness and swelling of the scaphoid-trapezium-trapezoid (STT/triscaphe) joint. This area is located by following the index meta-carpal proximally until a recess is palpated. This recess is the dorsal aspect of the triscaphe joint. Passive wrist flexion extension and radial/ulnar deviation were limited with tender end points. Passive forearm rotation was nontender. No other areas of tenderness or swelling were noted. This finding is similar to what is found in most patients with triscaphe degenerative arthritis.
Posteroanterior and lateral views of the right wrist revealed isolated loss of joint space and subchondral sclerosis of the triscaphe joint (Fig. 70—1). No other radiologic signs of degenerative joint disease were noted in the other areas of the hand or wrist.
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