Clinical Example: Congenital capitate malformation with capitate trapezoid articulation and scapholunate diastasis

This patient was evaluated for wrist pain following a wrist sprain. 

 
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Plain films demonstrate an unusual capitate contour, articulating with the proximal trapezoid. There is a wide scapholunate interval. 
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The scapholunate angle is abnormal, about 80 degrees.
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Radial and ulnar deviation views show minimal additional scapholunate widening in ulnar deviation.
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The opposite wrist is similar. This anatomy probably represents congenital carpal coalition between the capitate and an os centrale.
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