The Resolution
Diagnosis: Scapholunate dissociation. This is a significant ligamentous wrist injury. Findings on x-ray can be subtle but are important to identify. There is disruption of the scapholunate ligament with resultant instability.
 
Anteroposterior radiographs may demonstrate a widened scapholunate space (>3 mm), known as the Leon Spinks sign (a gap-tooth appearance; red arrow in Figure 2). This is best seen in clenched-fist views and posteroanterior views with the wrist in ulnar deviation.

Clinical Challenge: April, 2015
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