IS case 451: Madelung deformity
Imaging Sciences URMC 2010
Publication Date: 2010-08-30
Findings
Radiographic images of the bilateral forearms and wrists demonstrated features of Madelung deformity.
Diagnosis
Discussion
Madelung deformity is a developmental anomaly of the distal radius and carpus that usually presents in adolescent girls with decreased range of motion and pain in the wrist. The radiographic features involve deformities of the radius, ulna, and carpus, as described in this case (see figure legends). Dannenberg, et al. [2] have described criteria for diagnosis that include those deformities above, as well as decreased length of the radius, exostosis at the medial radius border, increased density of the ulnar head, and increased length of the ulna. The etiology is divided into posttraumatic deformities, dysplasias (multiple hereditary cartilaginous exostoses, Ollier disease, achondroplasia, multiple epiphyseal dysplasia, and the mucopolysaccharidoses), and hereditary and idiopathic conditions. There has been association with mesomelic dwarfism and a mutation on the X chromosome (e.g., Turner syndrome). Surgical treatment is indicated for pain relief and cosmetic improvement and includes a variety of ligament release, osteotomy, and arthrodesis procedures.
References
- Greenspan A. Orthopedic Imaging: A Practical Approach, 4th ed. Lippincott, Williams & Wilkins, 2004: 891-893.
- Dannenberg M, Anton JI, Spiegel MB. Madelung's deformity. Am J Roentgen Radium Ther Nucl Med. 1939;42(5):671-6.
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