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Hand & Upper Limb
intermediate
X-Type

Midcarpal Instability - Clunk Test and Dynamic Instability

Carpal Instability

A 28-year-old female presents with wrist pain and a "clunking" sensation during ulnar deviation. She denies specific trauma but notes generalized joint laxity. Examination reveals a positive midcarpal shift test with a palpable clunk during ulnar deviation with axial load. Radiographs appear normal. The surgeon suspects midcarpal instability. Regarding midcarpal instability (MCI):

Mark each as TRUE or FALSE

A

Midcarpal instability occurs at the MIDCARPAL joint between the proximal and distal carpal rows; it ...

B

The MIDCARPAL SHIFT TEST (clunk test) is pathognomonic: the examiner stabilizes the forearm in prona...

C

Midcarpal instability is classified as Carpal Instability Dissociative (CID) because the scaphoid an...

D

Etiology includes: generalized ligamentous laxity (most common), malunited distal radius fractures a...

E

Radiographic findings: STATIC radiographs are often NORMAL (dynamic instability); stress views or fl...

Answer the questions to see explanations

Click T (True) or F (False) for each option