Thread by @RyanChristieMD

#Wetread Case 17

Hx: Wrist pain

Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #MSKRad #orthorad

Social media breaks are a good thing!😁

#Wetread Case 18 Answer: Trans-scaphoid Perilunate dislocation

-lunate still "normal" position while other carpal bones dislocate dorsally
++ assoc scaphoid fx! ⭐️⭐️ (count the proximal row 😁)

#FOAMrad #FOAMed #mskrad #errad #orthorad

Perilunate Dislocation:

Mechanism: high-energy trauma (MVA) or FOOSH (fall on outstretched hand)

Injury: torn radioscaphoid, scapholunate & lunotriquetral ligaments

👀 for the scaphoid fx!

Perilunate Dislocation

Imaging:
-Frontal: lunate 🔺("pie sign") & overlaps capitate

-Lateral: lunate "normal"w other carpal bones dislocated (typically dorsal). Somtimes slight palmar tilt from the capitate trying to get back to normal
-capitate not sitting in "cup" of lunate

Perilunate Dislocation is often confused with LUNATE dislocation. Although there are similarities, just remember what is actually dislocating.

Is the lunate dislocated?
Yes=LUNATE dislocation
NO,but other bones dislocated? PERI-lunate dislocation
#FOAMed #FOAMrad #mskrad #errad