Madelung Deformity: A Case Report of a Young Nigerian Man

Abstract

The purpose of this article is to emphasise the influence of cultural orientation as a factor that could lead to delays in the diagnosis of some wrist deformities. This is important in improving the need for detailed clinical evaluation and judicious radiological investigation of wrist deformities so as to prevent undue physical, economic, and artistic losses among patients with such conditions. Madelung deformity involves the arrest of growth at the medial distal end of the radius, resulting in abnormal wrist alignment and angulation. It occurs more frequently in women than in men, and cases remain underreported despite the possibility of diagnosis using conventional radiography. A 27-year-old male patient presented with recurrent wrist pain and inability to use the right wrist. Clinical examination indicated the presence of a deformity affecting the right wrist. A right forearm X-ray, including the elbow and wrist joints in anteroposterior and lateral views, demonstrated lateral bowing of the radial shaft, widening of the interosseous space, a radial inclination angle of 34.68°, and positive ulnar variance. These findings were consistent with Madelung deformity. This case report highlights the value of obtaining a comprehensive clinical history, including relevant cultural considerations, alongside a thorough physical examination when diagnosing Madelung deformity. It also highlights the value of the early and judicious use of X-ray imaging as a diagnostic tool, even in low-resource settings. Early diagnosis facilitates timely conservative or surgical management, which is likely to result in better clinical outcomes while minimising economic and artistic losses for the patient. Furthermore, this report adds to the existing body of knowledge and contributes to promoting the early diagnosis and specialist management of Madelung deformity in low-resource settings through the effective use of conventional radiography.