X-rays were previously used to diagnose these injuries [
11‐
13], but we believe MRI scans provide a more accurate picture of the anatomical disruption including the soft tissue components [
6,
13]. MRI scans allows us to distinguish between intrinsic and extrinsic wrist ligament injuries as well as those of the TFCC complex. MRI sensitivity is 89%, specificity is 92% and diagnostic accuracy is 90%, and comparable to invasive methods, such as arthroscopy and arthrogram, providing relevant information to therapeutic decision [
6]. The TFCC can be better evaluated in the coronal plane from both T1 and especially T2, because the synovial fluid provides an “arthrogram” effect which makes the fracture easier to see. A normal TFCC in the coronal plane is seen as a structure with a hypointense, biconcave, triangular section between the lunar fossa of the radius and the styloid of the ulna. When a lesion exists, transverse fracture lines or shiny hyperintense signal perforations can be seen in the TFCC [
7,
8]. These injuries are common (38–55%) and of the degenerative type from the third decade of life, but are exceptional and of traumatic etiology in younger patients [
11,
13,
14]. These traumatic lesions are misdiagnosed in around 41% of the cases, coinciding with physeal wrist injuries and resulting in instability, functional loss of ROM and ocassionaly important cosmetic alterations [
4,
5,
14]. The closed reduction was impossible in this patient due to soft tissue interposition of the ECU and an open reduction was necessary before internal fixation [
1,
11,
12,
15]. In these injuries at wrist joint, the information provided exclusively from conventional radiology is incomplete. We agree with other authors that pathological balance, and therefore correct treatment of the injuries is not possible except with the use of non-invasive diagnostic methods such as MRI scans, which should be obtained in cases in which there are possible physeal lesions of both the ulna and the radius [
3,
6,
9].