Kienböck disease

Discussion:

Kienbock disease correspond to the avascular necrosis of the lunate.

Patients generally present with wrist pain that is worse with activities and more often occurs in the dominant hand.

Can be broken into 4 stages:

  • stage I - no changes on x-ray, but changes on MRI (edema and reduced vascularity of the lunate)
  • stage II - sclerosis of the lunate
  • stage IIIA - lunate collapse without scaphoid rotation
  • stage IIIB - lunate collapse with scaphoid rotation
  • stage IV - degenerated adjacent intercarpal joints

A common association is seen with negative ulnar variance

Treatment can be operative or non-operative. 

 

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