Differential Diagnosis for Subtle Non-Displaced Fracture of Distal Radius with Intra-Articular Extension and Lunate Bone Fracture
- Single Most Likely Diagnosis
- Fall onto an outstretched hand (FOOSH) injury: This is the most common mechanism of injury for distal radius fractures, and the presence of an intra-articular extension and a lunate bone fracture supports this diagnosis, as the force of the fall can transmit through the wrist, causing multiple fractures.
- Other Likely Diagnoses
- Osteoporotic fracture: The presence of a non-displaced fracture in an older adult could suggest an osteoporotic fracture, especially if there is a history of osteoporosis or minimal trauma.
- Chronic repetitive strain injury: Although less likely, repetitive strain on the wrist, such as from sports or occupational activities, could potentially lead to stress fractures in the distal radius and lunate bone.
- Do Not Miss Diagnoses
- Scapholunate advanced collapse (SLAC) wrist: Although the primary diagnosis is a fracture, it's crucial to assess the integrity of the scapholunate ligament, as an injury to this ligament can lead to SLAC wrist, a condition that significantly affects wrist function.
- Carpal instability: The intra-articular extension of the fracture and the involvement of the lunate bone necessitate an evaluation for carpal instability, which could require additional treatment to prevent long-term complications.
- Rare Diagnoses
- Kienböck's disease: A rare condition characterized by the collapse of the lunate bone due to avascular necrosis. While the acute presentation of a fracture makes this less likely, pre-existing Kienböck's disease could potentially weaken the lunate bone, making it more susceptible to fracture.
- Madelung's deformity: A rare congenital condition affecting the distal radius. Although not directly related to the acute fracture, it could be a predisposing factor for certain types of wrist injuries or fractures in younger patients.