Osteochondritis dissecans of the carpal scaphoid

Abstract

Fig. 1. Radiograph of wrist following trauma at age 13 years shows enlargement of joint space between scaphoid and lunate bone. The patient gave a history of trauma to his right wrist at the age of 13 years. At that time, the radiograph of the wrist showed some widening of the scapholunate joint space, which could be interpreted as a disruption of the scapholunate ligament, but was not diagnosed as such at that time (Fig. I). No bony injury could be seen. A plaster dressing was applied for 2 weeks. Following this episode, the patient's wrist had been functioning normally. On admission, swelling and limitation of wrist movements were noted. Radiographs of both wrists, taken in similar positions, showed features characteristic of osteochondritis dissecans of the right scaphoid (Fig. 2). Radiographs of the left wrist were normal. A plaster dressing was applied for 6 weeks to the forearm and wrist, followed by physiotherapy. Three months later, a full range of the wrist joint movements was obtained.