title: Occult Compression Fracture of Metacarpal Head without Evidence of Avascular Necrosis.
abstract: We report a case of 4th metacarpal head collapse of a 19-year-old healthy man. MRI revealed T1 low and T2 high regions in the collapsed 4th metacarpal head, as well as in the right 3rd and left 4th metacarpal head. Our initial diagnosis was occult compression fracture due to avascular necrosis, known as Dieterich's disease. However, pathological findings of surgically resected right 4th metacarpal head were compatible with transient osteoporosis and metacarpal head fracture followed by active tissue repair. The autologous osteochondral transplants from costchondral junction survived and maintained their size and shape even at 10-year follow-up.
authors.affiliation: Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.knishida@md.okayama-u.ac.jp.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashizume
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsukawa
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hashizume
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Shimamura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Torigoe
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D003937:Diagnosis, Differential; D050815:Fractures, Compression / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000473:pathology* / Q000601:surgery / Q000637:transplantation; D008663:Metacarpus / Q000002:abnormalities*; D010020:Osteonecrosis / Q000175:diagnosis*; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult