Abnormal type III fusion between lunate and triquetrum: A case report.

INTRODUCTION: The lunotriquetral coalition is the fusion of the lunate and triquetral bones of the wrist and is the most frequent carpal coalition type. It is frequently asymptomatic and discovered as an incidental due to chronic wrist pain, trauma, or fracture. This case aims to present an unusual unilateral lunotriquetral coalition and clinical significance for diagnosis and treatment. PRESENTATION OF CASE: In this case, we presented a 37-year-old male who exhibited with right-sided trauma and wrist pain. He was diagnosed to had a type III complete osseous lunotriquetral coalition on the right side and detected by plain radiography and CT without lytic, destructive, and sclerotic lesions. DISCUSSION: An avulsion fracture was recognized in the distal end of the right radius. A fragmented fracture was identified in the scaphoid bone, and an internal fixator extending from scaphoid bone to lunate bone. The internal fixators were observed among the lunate, capitate, and distal end of the radius bones. The plain anteroposterior, lateral radiograph and CT of the right wrist exhibited a right-sided unilateral type III osseous coalition between the lunate and triquetrum bones. CONCLUSION: Knowledge of type III complete fusion is essential to the proper diagnosis and management of this variation when a subject exhibits unexplained wrist pain, trauma, or fracture. It should be noted that plain radiographs and CT can provide an accurate diagnosis in type III complete lunotriquetral coalition without pathological evidence.

Evaluation of the gastro-oesophageal junction: defining the incompetent cardio-oeosophageal angle non-invasively with ultrasound and computerized tomography.

This study aimed to demonstrate the presence of gastro-oesophageal reflux disease (GORD) non-invasively using ultrasound (US) and computerized tomography (CT). Intra-abdominal oesophageal length (IAOL) and cardio-oesophageal angle (COA) were measured by US in 25 patients with known reflux and in 25 healthy subjects (control group). CT images of 42 patients with reflux disease and 44 controls were reviewed retrospectively, and IAOL and COA were measured on curved multiplanar format images. Using a cut-off value for IAOL of 20.5 mm, the sensitivity to detect GORD with US was 96% and the specificity was 80% and, with CT, the sensitivity was 95% and the specificity was 78%. A cut-off value of 138.5° for COA yielded sensitivity and specificity values for GORD detection of 76% and 72% with US and 83% and 80% with CT, respectively. In conclusion, with equivocal diagnostic findings, IAOL and COA are useful parameters that can be determined non-invasively by US or CT and may aid diagnosis and treatment choices for patients with suspected GORD.