Triquetral fracture

This is a patient who presented with chronic wrist pain and clicking. Frontal and lateral radiographs of the wrist were obtained. The frontal radiograph demonstrates no radiographic abnormality. On the lateral radiograph as indicated by the red arrow, there is a well corticated osseous fragment on the dorsal aspect of the carpus. The corticated appearance as well as the absence of overlying soft tissue swelling is consistent with a chronic ununited fracture. A fracture in this location is consistent with a triquetral fracture. The triquetrum is the second most commonly fractured carpal bone. The most common carpal fracture is a scaphoid fracture. These types of fractures are extremely difficult to diagnose on the frontal radiograph. The location of the fracture fragment is typical for a triquetral fracture.