Multifocal Avascular Necrosis of the Lunate and Triquetrum in a Child with Systemic Lupus Erythematosus

Avascular necrosis is a known complication of systemic lupus erythematosus. We report an unusual case of avascular necrosis affecting both the lunate and triquetrum in a child with this condition. Vasculitis, synovitis and IgM anticardiolipin antibodies were probable predisposing factors. The use of arthroscopic synovial debridement improves symptoms even in the presence of carpal chondromalacia and potentially delays the need for salvage surgery. *Corresponding author: Darren Roberts, Department of Hand, Plastic and Reconstructive Surgery, Birmingham Children’s Hospital, UK, E-mail: robertsdc@doctors.org.uk CASe RepORT