Avascular necrosis: capitate bone
Long-term history of wrist pain following a trauma, now with an increase in pain severity and limitation of movement.
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Fracture line within the proximal pole of the capitate associated with abnormally increased density of the whole capitate and multiple small areas of subchondral cystic changes.
Avascular necrosis (AVN) of the capitate is a very rare condition that manifests with a history of wrist pain resulting from an interruption of blood supply to the bone. This may be related to trauma or a variety of other conditions such as surgery, sickle cell anaemia, steroids and alcohol consumption. The patient had an old x-ray 10 months ago which showed a fracture to the capitate bone, however, she did not seek medical attention for months.
The CT findings are suggestive of type III AVN of the capitate.