Dorsal lunate tilt (DISI configuration): Sign of scaphoid fracture displacement

Douglas K. Smith, Louis A. Gilula, Peter C. Amadio

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Excessive dorsiflexion (dorsal tilting) of the lunate on a lateral wrist radiograph can be an important sign of carpal injury. Lunate dorsiflexion is a well-recognized sign of an intercarpal ligamentous injury pattern known as dorsal intercalated segment instability (DISI). It is less well recognized that excessive dorgal tilting of the lunate (DISI configuration) can also be produced by displacement of a scaphoid waist fracture. Since the management and prognosis of displaced scaphoid fractures may be quite different from those for nondisplaced fractures, radiologists can make an important contribution by recognizing dorsal tilting of the lunate and appreciating that it may be an important, indirect sign of scaphoid fracture displacement, which may not be directly visualized with standard wrist radiography. In this setting, computed tomography or complex motion tomography may be helpful for further evaluation of the scaphoid fracture.

Original languageEnglish (US)
Pages (from-to)497-499
Number of pages3
Issue number2
StatePublished - Aug 1990


  • Fractures, 4331.41, 4331.422
  • Ligaments, injuries, 493.483
  • Wrist, fractures, 4331.41
  • Wrist, injuries, 4331.43

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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