LAUSR

© BMJ Publishing Group Limited 2022. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION A man in his 50s had a fall from a motorcycle and sustained an injury to his left wrist. On examination, he was found to have tenderness over his wrist with range of movements of the wrist being restricted due to pain. On making a fist, the second metacarpal head was found to be in line with the third and found metacarpal heads (Murphy’s sign positive). Posteroanterior radiograph of the wrist was performed. It was confirmed to be a true posteroanterior view by the presence of the ulnar styloid medial to the ulnar shaft (figure 1A). The lunate was found to be malaligned, overlapping the scaphoid, triquetrum and capitate (figure 1B). Gilula’s second arc corresponding to the distal articular surface of the proximal carpal row was found to be disrupted (figure 1C). Lunate was found to be overlapping with the capitate, indicating the proximal migration of the capitate (figure 1D). A lateral radiograph of the wrist was performed. It was confirmed to be a true lateral view by the ulnar head being superimposed over the distal radius, overlap of secondfifth metacarpal shafts and the volar border of pisiform lying in the middle third of the scaphoid (figure 2A). The lunate was found to be volarly dislocated (figure 2B). The spilled teacup sign was noted (figure 2C). The radius and capitate were found to be aligned with the lunate volarly displaced and