First Reported Case of Unilateral Lunotriquetral Coalition in a Saudi Patient: An Incidental Finding.

Congenital carpal anomalies, ranging from extra bone formation to fusion or absence of existing ones, pose diagnostic challenges. Lunotriquetral coalition (LTC), an abnormal connection between the lunate and triquetrum bones, is a common anomaly. LTC can manifest as incomplete or complete fusion, often incidentally detected on radiographic imaging. Although predominantly congenital, LTC can also be acquired. We present the first reported case of unilateral LTC in a Saudi patient, discovered incidentally during evaluation of a radial collateral ligament injury of the thumb. LTC, the most common congenital carpal coalition, is classified into 4 types by Minnaar, based on the degree of fusion and associated anomalies. Typically asymptomatic, LTC may cause wrist pain, necessitating varied treatment approaches from conservative to surgical interventions. Our case underscores the importance of individualized management strategies for LTC and the relevance of careful radiographic evaluation in such diagnoses. Further research is needed to determine the incidence of LTC, particularly among the Saudi population, and to optimize treatment strategies.