Wrist Pain in Patient with Fracture History

Slideshow

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  Figure 1_1213 Clinical Challenge

  FIGURE 1. Standard films of the left wrist showed no osseous abnormality.

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  Figure 2_1213 Clinical Challenge

  FIGURE 2. A T1-weighted MRI image showing capitate involvement two weeks after presentation.

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  Figure 3_1213 Clinical Challenge

  FIGURE 3. A T2-weighted MRI image also displaying capitate involvement consistent with osteonecrosis.

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  Figure 4_1213 Clinical Challenge

  FIGURE 4. A three-month follow-up MRI scan shows early resolution on T1 images.

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  Figure 5_1213 Clinical Challenge

  FIGURE 5. A second MRI scan shows improvement on T2 images, with capitate showing similar signal to uninvolved wrist bones.

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  Figure 6_1213 Clinical Feature

  FIGURES 6A and 6B. At 10 months post initial presentation, plain films are consistent with normal radiographic anatomy.