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February 2002
By Theodore E. Keats, MD
A 25-year-old man has a painful and swollen wrist, which was injured
in a fall. What is your interpretation of the frontal and lateral
views of his wrist?
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ANSWER
The radiologic findings are typical of a perilunate dislocation
with associated fracture of the navicular. The frontal projection
(left) shows disruption of the arch configuration of the distal
portions of the proximal row of carpal bones with overlapping of
the distal row (arrows). In the lateral view (right), although the
lunate retains its normal relationship to the radius, the capitate
is dislocated posteriorly and no longer rests in the concavity of
the lunate (arrow).
Emerg Med 34(2):69, 2002
This series of diagnostic quizzes that challenge your ability
to read a variety of x-ray films is edited by Dr. Keats, professor
of radiology and professor of orthopedics at the University of Virginia
School of Medicine in Charlottesville.
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