This patient present with bilateral wrist pain after a fall. The first radiograph of the left wrist shows no evidence of fracture. The proximal carpal row appears to have one less bone than expected. However, the proximal carpal arc is preserved. In fact, the lunate and triquetrum are fused, a so called osseous lunotriquetral coalition. The second radiograph of the right wrist was obtained which confirmed that the coalition was bilateral as indicated by the red arrow. The green arrows points to a chronic united fracture of the ulnar styloid process.