The following wrist x-rays are from a 30 year old man who has presented after a FOOSH injury to his wrist. What can you see?
[peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”]The AP view of the wrist shows a screw placed in the scaphoid (scaphoid fracture from previous injury). But the carpal bones appear quite crowded as they should normally have a distance of 1-2 mm between them.
The lateral view shows a peri lunate dislocation. The capitate with its distal bony attachments is lying posterior to the lunate.
Thanks to John Larkin for the images.
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looks like a capito-lunate type of perilunate dislocation. “The apple has fallen out of the cup” when using the saucer-cup-apple system of describing the lateral view alignment of the scaphoid-lunate-capitate. here is a good picture outlining those 3 elements with same dislocation (on the right) http://www.imageinterpretation.co.uk/images/wrist/MIDCARPAL%20graphic.jpg