Avascular necrosis (AVN) of the carpal bones other than Kienböck disease is a rare
cause of chronic pain of the wrist. The scaphoid, capitate, and a smaller percent
of lunates are at greater risk to develop AVN because of their peculiar intraosseous
circulation; however, AVN has been reported in all the carpal bones. On the plain
radiograph, AVN of the carpal bones may evolve through a normal radiograph, sclerosis,
fragmentation, cyst formation, fracture, bone collapse, change of the carpal height,
and alignment and progressive degenerative changes of the wrist joint. In the early
stage of AVN, magnetic resonance imaging enhanced with gadolinium is a more sensitive
and specific diagnostic tool than plain radiograph to demonstrate the bone marrow
viability. Because of the rarity of case reports, the natural history of AVN of the
carpal bones other than Kienböck disease is not well understood. The aims of different
treatments are to prevent bone collapse, restore normal carpal height and alignment,
and reduce the risk of progressive degenerative changes of the wrist joint.
Key words
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Article info
Publication history
Published online: October 01, 2019
Accepted:
May 27,
2019
Received:
August 2,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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© 2020 by the American Society for Surgery of the Hand. All rights reserved.
