Imaging Case of the Week 379 Answer

The main abnormality on the left wrist x-ray is VISI (volar intercalated segmental instability) seen on the lateral view. To put it simply, volar tilting of the lunate.

The scapholunate angle is very narrow, about 15 degrees. The normal scapholunate angle which is the angle between the long axis of lunate & scaphoid on the lateral view should be 30-60 degrees.

This patient went on to have an MRI scan of the wrist which revealed VISI secondary to a lunotriquetral ligament tear.

Reference/ further reading: https://www.orthobullets.com/hand/6042/lunotriquetral-ligament-injury-and-visi