Health condition
Preiser disease
Preiser disease is avascular necrosis of the scaphoid without fracture - the wrist bone dies from failed blood supply rather than injury - causing radial-sided wrist pain that is frequently mistaken for a missed scaphoid fracture; MRI makes the distinction.
Why trust this guide
- 01
Editorial team
Written by our editorial team from the UK sources listed on each page.
- 02
Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
- 03
Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
-
Presents as pain and tenderness on the thumb side of the wrist without a convincing injury, or after trivial trauma, with reduced grip strength
-
MRI shows widespread ischaemia of the scaphoid without a fracture line - the feature separating it from post-fracture non-union avascular changes
-
Associations include steroid use, chemotherapy and connective tissue disease; the scaphoid’s retrograde blood supply is the anatomical vulnerability
-
Treatment ranges from splinting in early disease to vascularised bone grafting, and salvage surgery (scaphoid excision with partial fusion, or proximal row carpectomy) once the bone fragments and arthritis follows
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
The scaphoid’s blood enters at its far end and flows backwards, so its proximal portion lives on the far end of a narrow supply line - famous in fracture care, and the same vulnerability underlies the rare spontaneous necrosis Preiser described. The clinical picture mimics a scaphoid fracture that never appears on X-ray, and many patients cycle through repeated casts before MRI reveals the true diagnosis.
Diagnosis and treatment routes
Specialist assessment grades the disease by MRI and CT - how much of the bone is involved, whether it has fragmented, and whether surrounding joints show arthritis - alongside a review for steroid exposure and systemic associations. Early, contained disease may be treated with immobilisation and offloading; vascularised grafts from the distal radius offer a reconstruction window before collapse, and established fragmentation is managed with the wrist salvage procedures, chosen with an experienced hand surgeon around the patient’s work and hobbies. In much of the UK, a routine NHS referral to the relevant specialist clinic can take several months, whereas an initial appointment with a private consultant is typically available within around two weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant hand and wrist surgeon. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Preiser disease.
Quick, plain-English answers to what people ask us most.
-
What is Preiser disease?
Preiser disease is a rare condition involving loss of blood supply (avascular necrosis) to the scaphoid bone in the wrist, leading to bone death and, over time, wrist pain and dysfunction.
-
What causes Preiser disease?
The exact cause is often unclear, but it can follow trauma, be associated with certain underlying medical conditions, or occur idiopathically (without an identifiable cause) in some cases.
-
What are the symptoms?
Wrist pain, stiffness, and swelling, gradually worsening over time, are typical, sometimes following a relatively minor injury that wouldn't normally be expected to cause such prolonged symptoms.
-
Is Preiser disease serious?
It's not life-threatening, but it can cause progressive wrist pain and dysfunction if untreated, potentially leading to collapse of the scaphoid bone and secondary wrist arthritis over time.
-
Can Preiser disease be treated?
Yes, treatment options range from conservative measures like splinting and activity modification for early or mild cases, to surgical procedures aimed at preserving or reconstructing the bone for more advanced disease.
-
How is Preiser disease diagnosed?
MRI imaging is particularly useful for detecting early changes in blood supply to the scaphoid bone, often before changes are visible on standard X-rays, helping confirm the diagnosis.
-
How long does treatment take?
This varies depending on severity and treatment approach, from several weeks of conservative management for early cases to a longer recovery period, often several months, if surgical intervention is needed.
-
Preiser disease vs a simple wrist sprain — what's the difference?
A wrist sprain typically improves within weeks with rest and simple treatment, while Preiser disease causes persistent, often worsening symptoms due to the underlying bone blood supply problem, requiring specific imaging to identify.
-
Can Preiser disease lead to long-term wrist problems?
If not identified and treated appropriately, it can progress to bone collapse and secondary arthritis in the wrist, which is why early diagnosis and appropriate management are important for the best long-term outcome.
-
When should I see a specialist, and how quickly can I be seen privately?
See a hand and wrist specialist for persistent, unexplained wrist pain. Private specialist assessment, including MRI imaging, is typically available within about two weeks, considerably faster than standard NHS referral waiting times.