What does Ulnar Plus Variance mean? MRI Report included. Older wrist injuries..

[monarchbutterfly]

I have a few problems with my right hand/wrist. Pain on the thumb side of wrist and also more on the pinky side region of wrist (pinky side pain and clicking sounds) Basically ongoing for a few years and becoming worse.

Recently had a MRI (sports medicine doctor requested MRI). He did go over it with me however there is a  part of the MRI which was never discussed and something I don't understand.

If you don't mind here is what the MRI report says...

Clinical History... De Quervain's versus scapholunate injury. MRI Right Wrist.  There is mild plus variance. The TFCC, scapholunate, and lunotriquetral osseous ligaments all appear intact. There is a slight increased signal noted related to the extensor tendons of compartment one. Features would be consistent
with tenosynovitis. Carpal alignment is normal with no acute or healing fracture evident. Impression.. Tenosynovitis first extensor compartment.

So from what I understand is I have De Quervain's. The sports medicine doctor advice is to take Advil and didn't advise to purchase or wear a thumb splica splint. No cortisone injection mentioned either, maybe because my swelling wasn't too bad?

This is the term that I don't understand and wasn't discussed..."There is mild ulnar plus variance". That is something he didn't mention at that appt. I looked up the term on the internet and I am guessing this has nothing to do with De Quervain's?? Ulnar bone?

Should I be keeping an eye on this mild ulnar plus variance? I've had many wrist injuries  which were untreated in the past. Is mild ulnar plus variance genetic or caused by injuries? What is ulnar plus variance? I've never had surgery on this wrist. Treatments? Thank you for reading this and your help.

[Michael L Gross, MD]

The TFCC includes cartilage, tendons, and ligaments. The ulna plus variance is not the result of an injury, it is a normal variant of anatomy that predisposes you to wrist injuries.  If you are having recurrent injuries, then evaluation by a hand specialist might be a good idea.

[monarchbutterfly]

The TFCC is a ligament? So if it's torn or injured does that cause the ulna to be longer than the radius? The bone slips into a higher position, caused it to be longer? Or can fractures, even if not severe. cause this?

I've had numerous injuries to my wrist and hand that were never treated in the past. Only the past 1-2 years I've experienced problems with pain, clicking or clunking.

Thanks for your help!

[Michael L Gross, MD]

In most people, the ulna is shorter than the the radius. In a small percentage of individuals, the ulna is longer than the radius.  This is known as ulna plus variance. There is an a association with various injuries, such as those to the TFCC, but generally nothing is done unless problems develop.

[monarchbutterfly]

I forgot to add.. with the mild ulnar plus variance should I be seeing a specialist? I've had problems with my wrist for the past year. Thanks!

[monarchbutterfly]

Slighty mistake on my part...MRI report says mild ulnar plus variance, not mild plus variance.