Presentation
Fall onto outstretched hand. Pain on movement and tenderness around distal radius and base of hand.
Patient Data
A small fleck of calcification dorsal to the carpal bones on the lateral projection is consistent with a triquetral fracture.
The radius and other carpal bones are unremarkable.
Small fragment over the dorsal carpal bones on the lateral projection suggests triquetral fracture.
Case Discussion
Triquetral fractures are the most common carpal fracture after scaphoid fractures. Although they are usually managed conservatively, they are important to be aware of as they can be easily missed. Typically the only plain film evidence of injury is on the lateral view as in this case.
On some occasions, cross-sectional imaging is required to identify the avulsed fragment when there is clinical suspicion.
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