Idiopatic avascular necrosis of the capitate, Jonsson’s disease: a case report

Abstract

Introduction. Avascular necrosis (AVN) of the capitate bone is a rare disease of unknown etiology that usually appears in young people and causes chronic pain and functional impotence in the wrist. There are multiple treatments for this pathology; however, there is currently no clear consensus on the indications for these techniques.

Presentation of the case. A 27-year-old woman who attended the Orthopedic Surgery and Traumatology Service of a tertiary care institution for pain in the left wrist that she began eight months ago. As the only antecedent of importance, she had presented a blow in the area. No alterations were found in the X-ray presented by the patient. Nuclear magnetic resonance (NMR) was ordered, which showed an extensive trabecular fracture of the capitate with signs of pseudoarthrosis and bone edema, for which conservative management was initiated. In the follow-up MRI, performed one year later, persistence of bone edema was observed, so AVN of the capitate was suspected and a computerized axial tomography was performed, which confirmed the diagnosis. The patient was treated by arthroscopic resection of the proximal pole of the capitate with good short-term results.

Conclusion. It is necessary to carry out new studies with long-term results that compare the different therapeutic options to clarify the best treatment for this rare disease.