synonyms:avascular necrosis of the metacarpal head, Dieterich's diseasae, AVN metacarpal, osteonecrosis metacarpal
Dieterich's Disease ICD-9
Dieterich's Disease Etiology / Epidemiology / Natural History
- Most commonly affects Middle finger metacarpal head
- etiology: trauma, steriod use, systemic lupus erythematous
- Age: 6-54
- May resolve spontaneously in pediatric cases.
Dieterich's Disease Anatomy
- 35% of people lack main arteriole to the distal epiphysis with metacarpal head vascularity provided by small pericapsular arterioles.
Dieterich's Disease Clinical Evaluation
- Gradual pain onset, swelling, stiffness in MCP joint
Dieterich's Disease Xray / Diagnositc Tests
- AP, lateral, oblique view of hand demonstrate subchondral lucency, flattening of metacarpal head, sclerosis, cystic change, joint space loss.
- Consider MRI
- Consider ESR, coagulation screening, lupus screening, rheumatology screening
Dieterich's Disease Classification / Treatment
- Pediatric: may resolve spontaneously
- NSAIDs, activity modifications, splinting
- Surgical: decompression/curettage; volar flexion osteotomy, osteochondral mosaicplasty, arthrodesis, arthroplasty-Ascension Orthopedics
Dieterich's Disease Associated Injuries / Differential Diagnosis
Dieterich's Disease Complications
Dieterich's Disease Follow-up Care
Dieterich's Disease Review References
- Bhatia S, Orthopedic Today April 2014, 46