Imaging Case of the Week 46

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?

wrist x-ray AP

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wrist x-ray lateral

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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.

Perilunate dislocation

click to enlarge

Thanks to John Larkin for the images.

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