The patient is a 39-year-old woman who presented nocturnal paresthesia lasting for 6 months on both hands, but predominantly right (dominant hand). She presented mechanical pain of both wrists, with a visual analog score (VAS) of 90/100. Upon examination, there was a solid tumor on the posterior side of both wrists (Fig. 1), painful limitation of extension of the wrist and supination, mainly on the left side. The hemogram and blood chemistry were normal, as well as the neurophysiological study of the median and ulnar nerves. A karyotype demonstrated mosaicism (86% XX, 5% XXX, 9% X). The posteroanterior wrist X-rays (Fig. 2) showed typical Madelung deformity changes on the right wrist1: shortening of the radius compared to the ulna, dorsally and radially curved radius, dorsal and radial convexity, an angle similar to the distal radial joint surface, a mismatch of the distal radioulnar joint and carpal dislocation. The lateral projection (Fig. 3) demonstrated anterior arching of the radius and dorsal dislocation on the ulnar head; the carpus was also dislocated on the ulnar side and anteriorly in the distal radioulnar joint, in a way that made the wrist bones appear to follow the arch of the radius.2 The patient was diagnosed with a carpal tunnel syndrome due to Madelung’s deformity and was programmed for an evaluation by the orthopedics department but, due to a delay, medical treatment with local steroid infiltrations was carried out. 1 ml of triamcinolone was injected into the right wrist using a standard technique.3 The pain improved in the next 2 days (VAS: 50/100), disappearing completely after one week (VAS: 0/100).