This patient suffered a fall on an outstretched hand. She presented with tenderness on the dorsal surface of her wrist just distal to Lister's tubercle (distal dorsal radius). The PA radiograph shows widening (greater than 3mm) of the joint space between the lunate and scaphoid bones. This results from rupture of the scapholunate interosseous ligament in the setting of forceful extension of the wrist.

Patients with this injury require prompt referral to an orthopedic or hand specialist for either closed or open reduction. Failure to recognize and appropriately manage this injury can result in carpal instability and chronic pain.