Os centrale carpi simulating a scaphoid waist fracture

Area of Science:

• Orthopedic Surgery
• Radiology
• Anatomy

Background:

• The os centrale carpi is an uncommon accessory bone in the wrist.
• Its radiographic appearance can be mistaken for a scaphoid fracture, a common carpal injury.
• Accurate differentiation is crucial for appropriate patient management.

Observation:

• A case presented with plain X-ray findings suggestive of an un-united scaphoid fracture.
• Computed Tomography (CT) in the sagittal plane demonstrated two distinct, rounded fragments on the dorsal aspect of the scaphoid.
• These fragments exhibited smooth, regular cortical margins, unlike those seen in acute scaphoid fractures.

Findings:

• The combined volume of the fragments and scaphoid exceeded that of a normal scaphoid.
• No degenerative changes were observed in the fragments or the scaphoid bone.
• The imaging characteristics were inconsistent with an acute or un-united scaphoid fracture.

Implications:

• This case highlights the importance of advanced imaging like CT for diagnosing wrist pain.
• Distinguishing the os centrale carpi from a scaphoid fracture prevents unnecessary surgical intervention.
• Recognition of this anatomical variant aids in accurate diagnosis of soft tissue injuries.