Is Something Missing?

The x-ray in this photo tells a story. By looking at this x-ray you should be able to determine the patients diagnosis and what procedure was done or should be done to help this patient.

Moderator's Response
The patient has bilateral CMCJ OA. The left thumb has had an LRTI to reconstruct the tendon. The trapezium has been excised and this is noted by the spaceat the end of the first metacarapal. This patient also has pain in her right thumb and you can see that the right thumb is subluxing some with the stress view that you are seeing in this x-ray.