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Triquetral fracture-pooping duck sign

Case contributed by Irvine Sihlahla
Diagnosis certain

Presentation

Fall on an outstretched hand, painful left hand for 3 days

Patient Data

Age: 40 years
Gender: Female

Hand

x-ray
Frontal
Oblique
Lateral
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Info

The case illustrates a subtle fleck of avulsed bone posterior to the triquetrum giving the classical pooping duck sign of dorsal cortical triquetral fracture. The fracture is difficult to visualise on anteroposterior and oblique views. No other carpal bone fracture or dislocation was noted.

Zoomed view

x-ray
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Info

A zoomed view shows a fleck of avulsed bone posterior to the triquetrum consistent with the dorsal triquetral avulsion fracture.

Case Discussion

The case illustrates the classical pooping duck sign of dorsal cortical triquetral fracture. The triquetrum is the second most fractured carpal bone. Differentials would include accessory os triquetrum or os tringulare.

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