Perilunate Dislocation

• Perilunate fracture-dislocations occur two to three times more frequently than lunate dislocations.
• The lateral view shows the lunate in proper alignment with the radius. The capitate is dislocated.
• Three quarters of all perilunate dislocations are associated with a scaphoid fracture.
• AP view often reveals "crowded carpals" in which the proximal and distal rows of carpals are overlapped.

Look at the radiograph below and try to identify the dislocation. Remember that the capitate is dislocated in a perilunate dislocation. 

 

 Now look at the other images below. Realize that the dislocated capitate is very difficult to see in these views. Instead, crowded carpals are an indication of the dislocation.

Oblique View of Perilunate Dislocation

AP View of Perilunate Dislocation