The elusive bipartite scaphoid: a rare congenital variant or misdiagnosed pseudoarthrosis? Proposed new radiological criteria.

Variations in the development of carpal bones are uncommon, with the scaphoid bone typically forming from the fusion of the os centrale carpi and the radial chondrification centre during embryogenesis. A bipartite scaphoid is a rare congenital disorder that occurs when these ossification centres fail to fuse, with a prevalence ranging from 0.1% to 0.6% in adult dissection. Differentiating between a bipartite scaphoid and pseudoarthrosis is challenging, and complicates accurate diagnosis and evaluation. A 37-year-old male presented with right wrist pain following a minor fall. Physical examination revealed no visible deformity or swelling but a restricted range of motion due to pain. Radiographic imaging identified a bipartite scaphoid with two distinct, similar-sized ossification centres, regular oval shape, smooth margins, and consistent cortical-to-medullary ratio, with no acute fractures or dislocations. The patient was treated conservatively with non-steroidal anti-inflammatory drugs and immobilisation. Upon follow-up, the patient reported complete pain resolution and a full range of motion in the wrist. This case demonstrates the unusual occurrence of a bipartite scaphoid bone in a patient experiencing wrist pain after a minor injury. It highlights the challenge of differentiating between a congenital bipartite scaphoid and post-traumatic pseudoarthrosis, underlining the importance of taking into consideration this uncommon developmental variant when diagnosing and treating wrist pain.