Lunate dislocation

Case contributed by Dr Andrew Dixon

Presentation

Wrist pain following a fall.

Patient Data

Age: 20 years
Gender: Male
X-ray

There is fracture of the ulnar styloid. On the AP projection there is disruption of the normal alignment of the proximal carpal row with the lunate appearing triangular in shape and superimposed over the capitate.  Lunate dislocation is confirmed on the lateral film. 

Annotated images

Annotated image

On AP projection the lunate (blue) has taken on a triangular appearance, reminiscent of a slice of pie, and no normal lunatocapitate joint space can be seen. 

Lateral projection confirms ventral dislocation of the lunate (yellow). Note how the alignment of the distal radius (red) and the capitate (blue) are maintained (green line). 

Case Discussion

This case demonstrates the typical appearances of a lunate dislocation which represents a significant carpal injury. 

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