Presentation
Wrist pain and tenderness.
Patient Data
Sclerosis of the lunate bone with morphological preservation of the bone.
Negative ulnar variance.
MRI confirms the sclerotic changes involving the lunate as patchy low T1W and T2W signal intensity.
Associated intercarpal joint effusion.
Case Discussion
The case shows the typical features of Kienbock disease, in which the lunate bone undergoes osteonecrosis.
Plain films can show sclerosis or collapse of the lunate, or, in advanced cases, degenerative arthritic changes. However, a normal x-ray does not rule out milder disease. MRI is helpful in evaluating such cases, confirming suspected Kienbock disease as well as providing the stage of the disease.
The staging system used is the Stahl classification of Kienbock disease.
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