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I think the lunate-capitate alignment is ok. This is a case of Kienbock's disease, which is avascular necrosis of the lunate. Initially, radiographs are negative. Later, the bone becomes sclerotic on radiographs, which is why it appears asymmetrically denser compared to the remaining carpal bones. Eventually, you get collapse of the lunate, which leads to advanced secondary osteoarthritis. It is associated with negative ulnar variance, where the distal radial epiphysis protrudes distal to the distal ulnar epiphysis. One hypothesis, not proven, is that with negative ulnar variance,

Hi all, This radiologic sign is known as the "Double PCL sign." This is diagnostic of a bucket-handle tear of a meniscus, usually the medial meniscus, which is flipped into a position where it lies anterior to the PCL, and mimicks the appearance of a second PCL. In the above image, there is a curvilinear black structure originating from the distal femur, and then extending posteriorly and inferiorly to insert on the posterior aspect of the proximal tibia. This structure is the PCL. Just anterior to the PCL is a second, flatter, curvilinear structure interposed between the distal

A few months late, but thank you very much for your post. At the moment, I'm working a job that isn't bringing me closer to becoming a doctor, but the thought is still there, looming. Your kind words mean a lot to this stranger on the other end of the keyboard. Hi Julia, Thank you, really, for your great post. I honestly did not expect anybody to read this, so it's a nice surprise. Ya know, I don't know if I've truly carved out the "why" yet. "To help people" is kind of a weak reason. Many professions help people, so what sets medicine apart? Rereading my journal entry is interest

Nope. Scapholunate space refers to the joint space between the scaphoid and lunate, and therefore not the capitate/hamate. It is widened in scapholunate ligament disruption, which can lead to a SLAC (scapholunate advanced collapse) wrist deformity. Trapezium/trapezoid is often difficult to see well on radiographs just related to their shape and the beam projection on standard radiographs, but there's nothing overtly abnormal about them either. Ian