in Midcarpal Instability a painful clunk is present while testing the wrist in pronation as compared to testing insupination

Midcarpal Instability

First identified by Lichtman in 1980. Patients often present volar sag on the ulnar side of the wrist and give a history of painful “Clunk”. This is caused by laxity of proximal & midcarpal ligaments. Upon testing forearm pronation an obvious clunk is seen. During radio-ulnar motion – the palmar sag disappears with a catch-up clunk. Interestingly, a painful clunk is present while testing the wrist in pronation as compared to testing insupination.

Video Gallery

Clunk in Pronation
No Clunk in Supination
Midcarpal-Instability
Midcarpal Instability-1
Midcarpal Instability-quicktime
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