What causes spilled teacup sign in wrist on lateral radiograph?
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Answer:
Volar dislocation of the lunate seen in lunate dislocation, typically following high-energy trauma such as fall on outstretched hand, resulting in disruption of volar radiolunate and midcarpal ligaments with the lunate displacing volarly into the space of Poirier.
Why is it called so?:
The sign resembles a teacup that has been tipped over with its contents spilled forward, as the convex dorsal surface of the lunate loses articulation with the distal radius while the concave volar surface loses contact with the capitate, creating the appearance of volar tilt and displacement.
Pathophysiology:
High-energy hyperextension injury sequentially disrupts scapholunate interosseous ligament followed by capitolunate and radiolunate ligaments, allowing volar translocation and rotation of the lunate out of its fossa while the capitate migrates dorsally, producing the characteristic volar tilt on lateral view.
Alternative names: spilled tea cup sign
Other associated named signs: piece of pie sign, disruption of Gilula’s lines
Access all radiology signs posted so far: https://radiogyan.com/radiology-signs/
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