Kienbock's Disease
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Clinically Relevant Anatomy
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Mechanism of Injury / Pathological Process
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Clinical Presentation[edit | edit source]
Reports of activity-related dorsal wrist pain, limited wrist flexion and extension, and decreased grip strength. Swelling and tenderness may also be noted dorsally. More commonly, symptoms are in the dominant wrist and a history of trauma may be present. past.
Diagnostic Procedures[edit | edit source]
Plain radiographs are the primary modality for staging and treatment of Kienböck disease. There are 5 stages based on Lichtman's modification of Stahl's classification: Stage I-Normal; Stage II-Increased radiodensity of lunate with decrease of lunate height on radial side; Stage IIIa-Lunate collapse; Stage IIIb-Lunate collapse, fixed scaphoid rotation; Stage IV-Degenerative change of the lunate
Tomograms are used to determine the extent of the disease.
Bone scan helps to exclude the presence of Kienböck disease, but it is not specific enough to exclude the many other causes of increased uptake in the area of the lunate.
MRI is used early in the disease when plain films are not diagnostic. It is extremely sensitive and specific to detect osteonecrosis.
Outcome Measures[edit | edit source]
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Management / Interventions
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Differential Diagnosis
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Key Evidence[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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