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The Resolution
Diagnosis: The x-rays reveal a scapholunate dissociation (arrow).
Scapholunate dissociation is a significant ligamentous wrist injury. Findings on x-ray can be subtle, but are important to identify. There is disruption of the scapholunate ligament with resultant instability. AP radiographs may demonstrate a widened scapholunate space (>3 mm), known as the Leon Spinks sign (gap-tooth appearance) (yellow line). This is best seen in clenched-fist views and PA views with the wrist in ulnar deviation.
Acknowledgement: Case presented by Teleradiology Specialists (http://www.teleradiologyspecialists.com)
Clinical Challenge: October, 2014
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