A healthy 14-year-old male sustained a fall on his outstretched right hand while playing basketball. On physical exam, tenderness, decreased range of motion, and mild swelling of the right wrist joint was noted. Point tenderness over the anatomical snuffbox was also present. There was a very high clinical suspicion of scaphoid fracture due to the mechanism of injury and physical exam findings.
MRI obtained two hours after the injury demonstrated lipohemarthrosis. Fat within the joint fluid was definitely identified using the fat-saturation technique (Fig. 1). Double fluid-fluid levels were seen on both T1 as well as T2 sequences (Figure 1, Figure 2). A fracture of distal scaphoid bone was identified on anatomical (T1-weighted, Fig. 3), fluid-sensitive (fat-saturated T2-weighted, Fig. 4) and volume-rendered images (Fig. 5). The patient was treated with immobilization using a long thumb spica (fiberglass cast) for six weeks. After the removal of cast and physical therapy, the patient fully recovered and returned to normal baseline activity.