What is the Madelung deformity?
Madelung deformity is caused by epiphyseal growth plate disturbance at the ulnar side of distal radius, resulting in a short radius compared with the ulna.
The growth plate injury may be vascular, infectious, traumatic or muscular.
What conditions are associated with Madelung deformity? “HIT DOC”
Hurler’s syndrome (mucopolysaccharidosis), achondroplasia
Infection
Trauma
Dyschondrosteosis (mesomelic dwarfism)
Osteochondromatosis (diaphyseal aclasia)
Congenital Turner’s syndrome
What conditions are associated with Madelung deformity? “HIT DOC”
Hurler’s syndrome
Infection
Trauma
Dyschondrosteosis (mesomelic dwarfism)
Osteochondromatosis (diaphyseal aclasia)
Congenital Turner’s syndrome
Features of Madelung deformity
- Shortening and bowing of radius bones causing dorsal subluxation of the distal radioulnar joint.
- V-shaped proximal carpal row
- positive ulnar variance.
- pisiform can impacted against the ulna
What is pseudo-Madelung deformity?
Pseudo-Madelung deformity refers to increased radial inclination (i.e. ulnar tilt) of the distal radius but with negative ulnar variance and the absence of other typical features of Madelung deformity
What are the causes of pseudo madelung deformity?
- hereditary multiple exostoses
- post-trauma, e.g. physeal injuries
- rickets
- enchondromatosis - Ollier disease
- post-inflammatory or infectious arthritis
- achondroplasia
- mucopolysaccharidoses, e.g. Morquio syndrome, Hurler syndrome
What is metaphyseal flaring/Erlenmeyer flask deformity? LEAD Gnome (gnome storing calcified blood)
- Anaemias (thalassaemia, sickle cell anemia, pure red cell aplasia)
fibrous dysplasia - Storage diseases (Gaucher disease , Niemann-Pick disease)
- Bone dysplasias: fibrous dysplasia, multiple osteochondromatosis, enchondromatosis amongst many others
- Osteopetrosis
