Uncommon Presentation of Isolated Triquetral Osteomyelitis: A Rare Case Report

Osteomyelitis in the wrist is a rare musculoskeletal infection, accounting for about 1-6% of all wrist disorders. It generally relates to the carpal bones, metacarpals, or phalanges and frequently resembles other disorders such as acute synovitis. Timely diagnosis is difficult owing to ambiguous clinical and radiological indicators. Magnetic Resonance Imaging (MRI) is essential for early detection of bone involvement, although histology is the definitive diagnostic criterion. This case report describes the case of a 50-year-old male welder who experienced sudden pain, oedema, and limited mobility in the right wrist, absent any trauma history. The clinical assessment and MRI indicated osteomyelitis of the triquetral bone. Analysis in the laboratory revealed increased inflammatory markers. Surgical investigation disclosed necrotic dorsal interossei muscles and compromised synovium. Osteo decompression and debridement were carried out, and histopathological analysis verified acute-on-chronic osteomyelitis. The patient was administered culture-sensitive intravenous antibiotics, followed by oral antibiotics, resulting in excellent healing of the wound and full functional recovery around six weeks postoperatively. This case underscores the necessity of a heightened awareness of osteomyelitis in unusual presentations of wrist pain and emphasises the significance of prompt imaging, surgical intervention, and histological verification for timely diagnosis and effective therapy