Avascular necrosis of the proximal carpal row of the wrist. A possible complication of bisphosphonate administration.

Reports of coexisting osteonecrosis of more than one carpal bone are rare. We report an osteonecrosis of the entire proximal carpal row of the wrist, started briefly after intravenous bisphosphonate administration. The use of bisphosphonates for the treatment of osteoporosis is increasing. Osteonecrosis of the jaw (ONJ) is one of the known adverse effects during chronic treatment with bisphosphonates. This case is reported to make clinicians aware of a possible causative link between bisphosphonate use and osteonecrosis of other bones.