August 2022: A Video Game or a Wrist?

​Why does that lunate look like Pac-Man?I guess this was the first visual that came to mind because I grew up in the 1980s. Looking for the three Cs of the base of the capitate, the lunate, and the radius on the lateral happens without thinking after decades of looking at lateral wrist x-rays. You never want to miss a perilunate or lunate dislocation. A lunate dislocation is almost always volarly. Can you have a spilled teacup when the lunate seems nestled in the distal radius?The PA film makes it clear what happened here.​This patient has a lunotriquetral coalition, the most common congenital carpal bone fusion. It is more common in women (2:1 ratio), like my patient, often incidentally. These coalitions may be incomplete and bilateral.Don't mistake the lateral for a lunate dislocation. The PA image of the carpal bones should be extremely reassuring because Gilula's arcs are intact.Tip to RememberIt is important to know what normal looks like so you know abnormal when you see it.​Tags: X-ray, lunate, carpal bonePublished: 8/1/2022 10:13:00 AM
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs