Perilunate and lunate dislocations are best noted on lateral wrist radiograph. In both injuries, the normal alignment of the radius-lunate-capitate (the “3 C's” sign) is lost. With a perilunate dislocation, the lunate remains aligned with the radius, but the capitate is dislocated, usually dorsal to the lunate. With a lunate dislocation, the lunate dislocates volar to the radius, but the remainder of the carpus aligns with the radius. Lunate dislocation on PA radiograph has a triangular shape, the “piece of pie” sign, and on lateral view, the “spilled teacup” sign. Emergent consult for closed reduction or surgical repair is indicated.