Imaging Case of the Week 237 Answer

The frontal wrist x-ray shows a minimally separated intra-articular fracture of the radial styloid. There is also widening of the scapholunate interval, giving rise to the ‘Terry Thomas’ sign. The scapholunate interval is about 4.5 mm when measured; normal interval is < 2mm.

radial-styloid-fracture-with-scapholunate-disruption

ct-wrist

This patient was managed operatively.

The ‘Terry Thomas’ sign has been named after a famous British actor with a gap between his front teeth.

Never be satisfied after identifying one injury on the x-ray; always be on the lookout for additional injuries.