Ichchou L, Amine B, Hajjaj-Hassouni N
Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Rabat, Morocco.
Clin Rheumatol. 2008 Dec;27 Suppl 2:S47-50. doi: 10.1007/s10067-008-0865-5. Epub 2008 Mar 15.
Idiopathic avascular necrosis (AVN) of the capitate bone is an important, although rare, cause of spontaneous onset of wrist pain. Most cases involve direct or indirect trauma. Only a few reports of idiopathic avascular necrosis have been published. We present a case report of a 32-year-old woman who presented with a chief complaint of a left wrist pain, swelling and loss of all ranges of motions for approximately 1 year. She had no history of prior wrist trauma or steroid use. Laboratory testing for systemic disease or infection were negative. Diagnosis of avascular necrosis of the capitate has been made via plain film radiology, isotope bone scanning, and computed tomography scan. No etiologic factor could be identified. Surgical treatment was recommended, given drilling and autogenous bone grafting. Histological analysis showed necrotic bone. The physical therapy was implemented to restore function. Two months postoperatively, she was almost pain free.
头状骨特发性缺血性坏死(AVN)是腕部疼痛自发发作的一个重要原因,尽管较为罕见。大多数病例涉及直接或间接创伤。关于特发性缺血性坏死的报道仅有少数几例。我们报告一例32岁女性病例,其主要症状为左腕疼痛、肿胀以及所有活动范围丧失约1年。她既往无腕部外伤史或使用类固醇药物史。系统性疾病或感染的实验室检查均为阴性。通过X线平片、同位素骨扫描和计算机断层扫描确诊为头状骨缺血性坏死。未发现病因。鉴于需进行钻孔和自体骨移植,建议采取手术治疗。组织学分析显示为坏死骨。实施了物理治疗以恢复功能。术后两个月,她几乎不再疼痛。