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Title: What's the Diagnosis? Case submitted by Dr. Ryan Spangler

Category: Visual Diagnosis

Posted: 5/21/2013 by Haney Mallemat, MD

Question

30 year-old male presents with right wrist pain after falling off his bicycle. What's the diagnosis?

Answer

Scapholunate dislocation

 

Scapholunate Dislocation (a.k.a. “Terry Thomas” or “David Letterman” sign)

  • Increased distance between the scaphoid and lunate bones on AP wrist X-ray; the distance between the two bones should normally be less than 2mm.
  • A widened scapholunate distance suggests ligamentous injury or tear (green arrow below).
  • The widened distance resembles the famous dental diastema (i.e., tooth gap) of Terry Thomas (British comedian) and David Letterman

 

References

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