Carpometacarpal Joint Injury

The CMC joint intervals should look relatively uniform on the AP radiograph.  We can appreciate that the 4th and 5th CMC joints demonstrate abnormal overlap with the distal hamate when they should look look similar to the clean uniform lines of the 2nd and 3rd .

Also, the dorsal line of the CMC joint should be relatively smooth, only making a shallow concavity at the distal carpal row.  There is clearly an abnormal jutting of bone dorsally on this film coming from the distal carpal row.  You can see one of the proximal metacarpal bases following with it.

This patient had a very unusual coronally oriented hamate fracture.  Punched a wall and found out which gave first.