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However, an accessory muscle was seen attached to the index finger FDS tendon in zone 3.

A tendon ran proximally from this accessory muscle belly into the forearm.

The first purpose of this study was to examine the reliability and reproducibility of the two methods of determining the lunate type: posteroanterior (PA) radiographic analysis (PA analysis) and capitate-triquetrum distance analysis (CTD analysis).

The second purpose was to investigate the compatibility of the radiographic classification of lunate types with MR arthrography (MRA) findings.

Of note, pre-operatively he had a very tight FPL and wrist flexors but also incidentally a severe flexion deformity of his ring little and fingers which resembled a claw hand.

During surgical exploration and release of the muscles, an anomalous fusiform muscle was found originating from the tendon of the FPL, heading to the ring finger and flexing the distal interphalangeal joint.

The PA analysis and MRA findings for the detection of medial facets of the lunate were compatible in 119 of the 150 patients (79.3%).

Twenty-eight (90.3%) of a total of 31 incompatible wrists had a medial facet on the lunate on MRA (Type II), which was undetected on the PA analysis (Type I).

We present the case of a 28 year old male mechanic who presented with a painful swelling over his right thenar eminence following a road traffic accident.His grip strength was compromised and had reduced abduction of his index finger. No intrinsic muscle rupture was detected and no mass lesion was detected.Hypertrophy of the index intrinsic muscles was suggested.The Cohen kappa and Fleiss kappa statistics were used for estimating the intra- and inter-observer reliabilities.The compatibility of the lunate types with the MRA findings, as assessed by each observer, was investigated.

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On the CTD analysis, 76 (50.7%) of the total wrists were classified into the intermediate group; excluding them, 27 of 29 Type II lunates (93.1%) and 39 of 45 Type I lunates (86.7%) were compatible with the MRA findings.

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