Bilateral Congenital agenesis of the Proximal Pole of the Scaphoid: A Rare Variant of Carpal Anatomy

Introduction: Congenital anomalies of the carpus are rare, and scaphoid agenesis is an exceptionally uncommon condition. Most reported cases involve unilateral absence and are frequently associated with other malformations such as thumb hypoplasia or radial hemimelia. No previous reports have described isolated bilateral agenesis of the proximal pole of the scaphoid.

Materials and Methods: We present the case of a 32-year-old male evaluated for intermittent right-wrist pain. Clinical examination was complemented with bilateral wrist radiographs, computed tomography, and magnetic resonance imaging to characterize carpal anatomy and exclude associated abnormalities.

Results: Imaging revealed bilateral congenital agenesis of the proximal pole of the scaphoid with preservation of the distal portion. No additional skeletal, systemic, or soft-tissue anomalies were identified. The patient had no significant medical or family history of congenital disorders. Physical examination demonstrated normal wrist alignment, full range of motion, and no functional limitations. Because symptoms were mild and the wrist remained stable, conservative management with periodic follow-up was recommended.

Discussion: This appears to be the first documented case of isolated bilateral congenital agenesis of the proximal pole of the scaphoid. The patient’s benign clinical course supports a non-interventional approach. Recognition of this rare variant is crucial to avoid misdiagnosis, particularly confusion with post-traumatic conditions.

Conclusion: Isolated bilateral congenital agenesis of the proximal pole of the scaphoid represents a previously undescribed anatomical variant. Awareness of this condition may prevent unnecessary interventions and contributes to understanding congenital carpal anomalies.