Avascular necrosis of scaphoid bone


  • A 54 years old man
  • History of trauma few years ago
  • Pain at right wrist region after the trauma
MRI of wrist in coronal plane

MRI findings:

  • There is fracture at the scaphoid waist
  • The proximal pole of fracture fragment (arrow) is small in size
  • It also shows abnormal signal intensity
  • The distal fracture fragment is normal in size, however irregular outline distally and cystic change within it suggestive of arthritis
  • Abnormal signal in adjacent extensor carpi radialis tendon

Diagnosis: Avascular necrosis of scaphoid


  • Scaphoid fractures are common, however can be difficult to diagnose.
  • Early detection and treatment is important to prevent complication including avascular necrosis and painful arthritis
  • Avascular necrosis is common in scaphoid fracture due to its peculiar blood supply
  • Occurs in 15-30% of scaphoid fractures
  • Almost always involves the proximal pole
  • The more proximal is the fracture line, the risks of avascular necrosis increase
  • The radiographic hallmarks of AVN are collapse and fragmentation
  • MRI is more sensitive to detect AVN than conventional radiographs
Author: radhianahassan