View source for Scapholunate dissociation

==Background==
*Caused by rupture of scapholunate ligament
**Most commonly injured ligament of the wrist
*Injury most commonly occurs from FOOSH

==Clinical Features==
*Pain/swelling on radial side of wrist
*"Clicking" sensation with wrist movement

==Evaluation==
===Imaging===
[[File:Scapholunate Dissociation.jpg|thumb|Black arrow: Scapholunate joint space widening; White arrow: Cortical ring sign]]
[[File:Dorsal_Intercalated_Segment_Instability.jpg|thumb|Dorsal intercalated segment instability]]
*A grip compression view or wrist in ulnar deviation may be necessary in addition to PA/lateral views
*Any of the following signs may be seen:
**Widening of the scapholunate joint space >3mm
***Known as Terry-Thomas sign (or David Letterman sign)
**Rotary subluxation of the scaphoid
***Lateral view: Scapholunate angle >60 degrees
***PA view: Cortical ring sign (circular cortex of the bone is more prominent)
**Dorsal intercalated segment instability
***Dorsal angulation of lunate relative to radius resulting in capitolunate angle > 20°
***Seen as loss of the normal collinear arrangement of the capitate, lunate, and radius

==Differential Diagnosis==
{{Carpal dislocation DDX}}

{{Carpal fractures}}

==Management==
*[[Radial gutter splint]] or [[forearm volar splint]]
*Ortho referral

==Disposition==
*Generally outpatient follow-up

==References==
<references/>

[[Category:Orthopedics]]