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.
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- Idiopathic bilateral lunate and triquetrum avascular necrosis: a case report.Hand Surg Rehabil. 2016; 35: 367-370
- Vascularity and osteonecrosis of the wrist.Orthop Clin North Am. 2004; 35: 405-421, xi
- Bilateral avascular necrosis of the trapezoid.J Hand Surg Am. 2011; 36: 1678-1680
- Nontraumatic osteonecrosis of the capitate bone associated with gout.Ann Chir Main Memb Super. 1993; 12: 210-212
- Avascular necrosis of the pisiform.J Hand Surg Br. 2006; 31: 453-454
- Avascular necrosis of trapezium bone: a case report.J Hand Surg Am. 2002; 27: 704-706
- Idiopathic avascular necrosis of the scaphoid.J Hand Surg Br. 1994; 19: 174-182
- Bilateral idiopathic avascular necrosis of the scaphoid: a rare case of Preiser’s disease.J Bone Joint Surg Br. 2009; 91: 1400-1402
- Preiser’s disease: identification of two patterns.J Hand Surg Am. 2003; 28: 767-778
- Idiopathic avascular necrosis of the scaphoid: 10 new cases and a review of the literature. Indications for Preiser’s disease.Orthop Traumatol Surg Res. 2012; 98: 390-397
- Preiser disease.J Hand Surg Am. 2013; 38: 1833-1834
- Post-traumatic avascular necrosis of the proximal 197 carpal row—a case report.Hand Surg. 2015; 20: 466-470
- Nonspecific avascular necrosis of the pisiform bone: a case report.J Hand Surg Am. 1980; 5: 341-342
- Idiopathic aseptic osteonecrosis of the capitate bone. Literature review apropos of 3 new cases.Int Orthop. 1991; 15: 85-94
- Avascular necrosis of the hamate: three cases and review of the literature.J Wrist Surg. 2014; 3: 269-274
- Avascular necrosis of the capitate: report of six cases and review of the literature.J Hand Surg Eur. 2015; 40: 520-525
- A case of trapezium avascular necrosis treated conservatively.Case Rep Orthop. 2017; 2017: 6936013
- Avascular necrosis of the triquetrum: a case report.Hand Surg. 2005; 10: 91-94
- Avascular necrosis of the trapezoid bone.J Hand Surg Br. 1998; 23: 550-551
- Osteonecrosis of the trapezium treated with a vascularized distal radius bone graft.J Hand Surg Am. 2004; 29: 1098-1101
- The arterial anatomy of the human carpus. Part II: The intraosseous vascularity.J Hand Surg Am. 1983; 8: 375-382
- Avascular necrosis of the hamate treated with core decompression: a case report.J Hand Surg Eur Vol. 2018; 43: 778-780
- Bilateral aseptic necrosis of the os pisiforme.Z Orthop Ihre Grenzgeb. 1968; 104: 590-591
Published online: October 01, 2019
Accepted: May 27, 2019
Received: August 2, 2018
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