Traumatic lipohemarthrosis of the wrist joint in association with a scaphoid fracture is an unreported entity. We present the first case report of MRI appearance of a double fluid-fluid level of lipohemarthrosis caused by a scaphoid fracture. The presence of a double fluid-fluid level within the injured joint definitely establishes a lipohemarthrosis. A traumatic lipohemarthrosis is considered synonymous with an intra-articular fracture and has important implications for patient management. A limited MRI scan for diagnosis or exclusion of scaphoid fracture may be more cost-effective than expectant management and subsequent followup visits.