Idiopathic avascular necrosis of the scaphoid: Preiser's disease.

Preiser's disease, or idiopathic avascular necrosis of the scaphoid, is a rare, albeit often debilitating, condition. Although unknown, the etiology is probably multifactorial, with biomechanical or anatomical variations leading to an "at risk" scaphoid. Most commonly the diagnosis is made with the use of plain radiographs, but one should not hesitate to use MRI for both confirming the diagnosis and evaluating the stage of the disease. Current treatment algorithms are not standardized, and many scaphoids degenerate to a point that a salvage procedure is required. The authors attempt a revascularization procedure if the disease is caught early and the scaphoid has not yet gone on to collapse and degenerate. We save our salvage procedures for advanced cases with periscaphoid arthritis.