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Dietrich disease

Case contributed by Dr Andrew Dixon ◉

Diagnosis certain

Diagnosis certain

Presentation

Woman investigated for bilateral hand pains.

Patient Data

Age: 45

Gender: Female

From the case: Dietrich disease

X-ray

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Frontal

Hand radiographs demonstate abnormality of the bilateral 3rd and right 2nd metacarpal heads. There is contour deformity of the heads and a mixed lucent and sclerotic appearance to the subchondral bone. These findings are consistent with avascular necrosis which in this location has the eponymous name: dietrich disease.

There is possible erosion of the right ulnar styloid process and therefore a superimposed erosive arthropathy such as rheumatoid arthritis needs consideration.

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