We present a case of a 26-year-old patient who came to the consultation for pain in the right wrist of 7 years of evolution without traumatic history.
Pain at rest was mild, but increased with manual activity and especially with forced wrist extension.
The patient did not improve with symptomatic medical treatment.
The dorsal radiologic articular interline and the proximal pole of the scaphoid were painful to fixation.
No palpable tumor was observed.
The mobility of the wrist presented a slight limitation in the last degrees of flexion and extension.
The radiological image showed a well-defined radiologic lesion, oval, located in the middle-dorsal third of the scaphoid.
The CT scan showed the eccentric dorsal location of the lesion and a stab compatible with calcifications.
MRI showed signs of marked bone edema in the scaphoid, except in the distal third and adjacent synovitis.
With the diagnosis of suspected benign lesion (enchondroma, intraosseous dilatation), surgical treatment of the lesion was decided.
This was performed using a dorsal approach of the scaphoid.
After opening the articular capsule, the dorsal aspect of the distal epiphysis of the radius and the scaphoid was exposed. In the middle third of the latter, a red, red, naked bone was observed.
Complete curettage of the lesion and filling of the defect with spongy bone graft of the iliac crest was performed.
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The material was composed of islets of cartilaginous matrix surrounded by abundant cellular tissue consisting of pseudo-coarse textures.
These cells were rounded or ovoid with hyperchrocytic nuclei, a clear or moderately eosinophilic cytoplasm and a clear plasma membrane.
Cell pleomorphism was minimal and mitotic index was very low.
Some cells contained iron.
Giant cells of osteoclastic type were found in pseudo-colony cells.
In some areas there were areas of irregular qualification.
Cystic transformation areas resembling aneurysm cysts were also observed.
The anatomopathological diagnosis was chondroblastoma of the scaffold.
1.
After surgical treatment, the wrist was immobilized with an antebrachial splint for 3 weeks and then the patient was referred to the Rehabilitation Service.
In the review performed at 3 months, full recovery of wrist mobility and radiological image of bone consolidation of the iliac crest autoinjection were observed.
Two years after the surgical treatment there is no evidence of recurrence and there is a complete disappearance of pain with wrist mobility similar to the contralateral, as well as a radiological image of the scaphoid totally normalized.
