Images in Radiology - Bilateral Congenital Capitate-Hamate Fusion

A 14-year-old Hispanic boy, a high-end soccer player, presented to us following injury to the knee. There was an epiphyseal injury (type III Salter-Harris) to the lower femoral epiphysis on the right side. It was surgically treated and the leg was placed in a cast. During the course of management of the femoral fracture, wrist and hand x-rays were taken for determination of bone age to help predict any possible development of limb-length discrepancy/deformity with remaining skeletal growth. Bilateral capitate-hamate coalition was incidentally detected (figure 1). There were no symptoms in both wrists and physical exam findings were normal. In view of full function and asymptomatic nature of the condition no intervention was done for the carpal coalition although the patient was made aware of the findings and the possible implications.