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Vibration-induced multifocal carpal osteonecrosis in a 31-year-old man
  1. Muhammad Awais1,
  2. Saima Hafeez1,
  3. Abdul Rehman2,
  4. Noor Ul-Ain Baloch3
  1. 1Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  2. 2Internal Medicine Section, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
  3. 3Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Muhammad Awais, Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi, Sindh 74800, Pakistan; awais_aku{at}

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Hand–arm vibration syndrome (HAVS) is common among lumberjacks, riveters and pneumatic drillers.1 This syndrome encompasses a group of vibration-induced vascular and neurological disorders, which commonly manifest as Raynaud's phenomenon, peripheral neuropathy and muscular weakness.2 However, vibration-induced bone and joint disorders are less common and mild in most cases.3 We recently encountered a patient with multifocal carpal osteonecrosis that was most likely attributable to prolonged vibration exposure.

A 31-year-old construction worker presented with severe right-sided wrist pain for the past 3 weeks. He reported working with pneumatic drills for the past 12 years with an average vibration exposure of 5 h per day for 5 days a week. On physical examination, the range of movement of …

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  • Contributors MA and AR were involved in the conception, design and data acquisition; SS and NU-AB were involved in the revision for important intellectual content; all authors were involved in the preparation of the manuscript and approval of the final version to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.