The 'Spilled teacup sign' on a lateral X-ray of the wrist indicates which dislocation?

• A. Perilunate Dislocation
• B. Lunate Dislocation
• C. Capitate Dislocation
• D. Scaphoid Fracture

Answer: (B)

This item tests recognizing the spilled teacup sign on a lateral wrist X-ray, which is specific for lunate dislocation. When the ligaments holding the lunate fail, the lunate shifts volarly (toward the palm) and loses its normal rounded alignment. On a lateral view it tilts forward like a teacup tipping over, giving the characteristic sign. This is a high‑stakes injury because it can compress the median nerve and risks lunate avascular necrosis if not promptly managed. The usual approach is emergent reduction and immobilization, with orthopedic evaluation for possible ligament repair or further intervention. This sign distinguishes lunate dislocation from other wrist injuries, where the radiographic patterns involve different bones or alignments rather than a forward-displaced lunate.