Presier’s disease: idiopathic avascular necrosis of scaphoid in a case presenting with wrist pain in young male

Authors

  • Pokhraj P. Suthar Department of Radiology and Imaging Sciences, Sterling Hospital, Vadodara, Gujarat, India
  • Gaurav R. Parmar Department of Radiology and Imaging Sciences, Paramount Diagnostic and Research Centre, Vadodara, Gujarat, India
  • Chinmay Trivedi Department of Critical Care, Bhailal Amin Hospital, Vadodara, Gujarat, India
  • Hemen I. Vithlani Department of Radiology and Imaging Sciences, Sterling Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20173593

Keywords:

AVN, MRI, Wrist joint

Abstract

A 25-years-old male presented with complain of pain in right wrist and difficulty in gripping objects. No history of trauma to the right wrist joint. On local examination, tenderness was present in right anatomical snuff box. Tenderness was elicited by axial compression on right first metacarpal with decreased range of the motion at the right wrist compare to the left side. Routine blood investigation was within normal limits. X-ray of the right wrist joint showed minimal sclerotic in right scaphoid. On MRI right wrist joint, low intensity signal was seen involving the whole right scaphoid bone on T1 weighted, T2 weighted and STIR images with loss of normal marrow signal intensity. So according to the Herbert and Lanzetta it was stage 4 and Kalainov et al, type 1 avascular necrosis.  Diagnosis of idiopathic avascular necrosis of the right scaphoid bone was postulated based on clinical and radiological findings. Patient was treated with vascularised pedicle bone graft from the right distal radius. The patient was gradually improved clinically with subsidence of pain and improvement in the grip strength over 1 year.

References

Lenoir H, Coulet B, Lazerges C, Mares O, Croutzet P, Chammas M. Idiopathic avascular necrosis of the scaphoid: 10 new cases and a review of the literature. Indications for Preiser's disease. Orthopaedics Traumatol Surg Res. 2012;98(4):390-7.

Taleisnik J, Kelly PJ. The extraosseous and intraosseous blood supply of the scaphoid bone. J Bone Joint Surg Am. 1966;48-A:1125-37.

Bonzar M, Firrell JC, Hainer M, Mah ET, McCabe SJ. Kienbock disease and negative ulnar variance. J Bone Joint Surg Am. 1998;80:1154-7.

Herbert TJ, Lanzetta M. Idiopathic avascular necrosis of the scaphoid. J Hand Surg Br. 1994;19:174-82.

Kalainov DM, Cohen MS, Hendrix RW, Sweet S, Culp RW, Osterman AL. Preiser’s disease: identification of two patterns. J Hand Surg. 2003;28:767-78.

Karantanas A, Dailiana Z, Malizos K. The role of MR imaging in scaphoid disorders. Eur Radiol. 2007;17:2860-71.

Vidal MA, Linscheid RL, Amadio PC, Dobyns JH. Preiser’s disease. Ann Chir Main Memb Super. 1991;10:227-35.

Menth-Chiari WA, Poehling GG. Preiser’s disease: arthroscopic treatment of avascular necrosis of the scaphoid. Arthroscopy. 2000;16:208-13.

Hayashi O, Sawaizumi T, Nambu A, Ito H. Closing radial wedge osteotomy for Preiser’s disease: a case report. J Hand Surg Am. 2006;31:1154-6.

Harpf C, Gabl M, Reinhart C, Schoeller T, Bodner G, Pechlaner S, et al. Small free vascularized iliac crest bone grafts in reconstruction of the scaphoid bone: a retrospective study in 60 cases. Plast Reconstr Surg. 2001;108:664-74.

Moran SL, Cooney WP, Shin AY. The use of vascularized grafts from the distal radius for the treatment of Preiser’s disease. J Hand Surg Am. 2006;31:705-10.

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Published

2017-07-26

How to Cite

Suthar, P. P., Parmar, G. R., Trivedi, C., & Vithlani, H. I. (2017). Presier’s disease: idiopathic avascular necrosis of scaphoid in a case presenting with wrist pain in young male. International Journal of Research in Medical Sciences, 5(8), 3720–3722. https://doi.org/10.18203/2320-6012.ijrms20173593

Issue

Section

Case Reports