The combination of radiographic findings and the patient's presentation in this case suggest multicentric reticulohistiocytosis (MCRH) as a diagnosis, but do not rule out other differential considerations such as rheumatoid arthritis and other inflammatory arthritides or gout. If only the pan-carpal destructive changes in the left wrist are identified, septic arthritis would be an important consideration.
This case was biopsy proven MCRH.