distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: may 8,...

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distal ulna; no reconstruction ♂ 22yo, craftsman 1st referral: May 8, 2013 HPI: • Minor trauma (contusion lower arm) early March 2013 • On April 12, 2013 infiltration with Kenacort by family physician • Since then, severe swelling in the area of the distal ulna • Slightly improving after application of NSAI • No B symptoms PMH: • Healthy

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Page 1: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction

♂ 22yo, craftsman 1st referral: May 8, 2013

HPI:

• Minor trauma (contusion lower arm) early March 2013

• On April 12, 2013 infiltration with Kenacort by family physician

• Since then, severe swelling in the area of the distal ulna

• Slightly improving after application of NSAI

• No B symptoms

PMH:

• Healthy

Page 2: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction

Clinical findings:

• Soft tissue swelling in the distal ulna on the right side on palpation

• Tender to palpation

• Mobility of the wrist free, but restricted by pain

Page 3: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction x-ray wrist right: May 6, 2013

Page 4: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction x-ray wrist right: May 8, 2013

T1 T2

Page 5: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Clinical pics: May 8, 2013

Page 6: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Clinical pics: May 8, 2013

Page 7: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction x-ray wrist right: May 8, 2013

T1+KM

ECU

Radius Radius

FCU FDP/FDS

EDC

U R M U

u

U = ulnar nerve, R.dorsalis

Page 8: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction CT-guided Biopsy: May 13, 2013

Page 9: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Result: Histology: May 13, 2013

Page 10: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Result: Histology: May 13, 2013

Page 11: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Result: Histology: May 13, 2013

Page 12: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Result: Histology: May 13, 2013

Page 13: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Histology: May 13, 2013

Page 14: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Surgery: Jun 18, 2013

Page 15: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Surgery: Jun 18, 2013

Hand Proximal

Tumor

Ulna

Page 16: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Surgery: Jun 18, 2013

Ulnar nerve

Ulnar artery

Page 17: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Surgery: Jun 18, 2013

Ulna

Pronator quadratus

Cartilage of

DRUG

Page 18: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Surgery: Jun 18, 2013

Page 19: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Surgery: Jun 18, 2013

cartilage of ulna

Page 20: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction postop x-ray, June 19 2013

Page 21: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Histology: June 19, 2013

Page 22: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Histology: June 19, 2013

Page 23: distal ulna; no reconstruction...distal ulna; no reconstruction 22yo, craftsman 1st referral: May 8, 2013 HPI: •Minor trauma (contusion lower arm) early March 2013 •On April 12,

distal ulna; no reconstruction Histology: June 19, 2013

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