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Avascular necrosis of the lunate bone (Kienböck's disease) secondary to scapholunate ligament tear as a consequence of trauma - a case study.

Kulhawik D, Szałaj T, Grabowska M - Pol J Radiol (2014)

Bottom Line: Early diagnosis and treatment can prevent progression of necrotic lesions and bone collapse.Arthro-MRI examination also allows us to identify the underlying ligamentous injury.In cases of traumatic etiology, an additional CT test enables stating the final diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging Diagnostics, Independent Public Clinical Hospital, Otwock, Poland.

ABSTRACT

Background: Avascular necrosis of the lunate bone (Kienböck's disease), is a condition in which lunate bone, loses its blood supply, leading to necrosis of the bone. There is probably no single cause of Kienbock's disease. Its origin may involve multiple factors, such as the blood supply (arteries), blood drainage (veins), and skeletal variations. Trauma, either isolated or repeated, may possibly be a factor in some cases. This case presented with multifactorial etiology.

Case report: In the presented case, a patient with negative ulnar variant had injured her right wrist and presented at an orthopedic clinic due to nonspecific pain 6 months later. An arthro-MRI examination revealed necrosis of the lunate bone, scapholunate ligament tear and coexisting TFCC (triangular fibrocartilage complex) tear.

Conclusions: Early diagnosis and treatment can prevent progression of necrotic lesions and bone collapse. MRI examination seems to be the key diagnostic method in the early stage of the Kienböck's disease with negative x-ray and CT images. Arthro-MRI examination also allows us to identify the underlying ligamentous injury. In cases of traumatic etiology, an additional CT test enables stating the final diagnosis.

No MeSH data available.


Related in: MedlinePlus

(A) MRI, T2-weighted image. (B) MRI arthrogram, T 1-weighted image. (C) CT arthrogram.
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Related In: Results  -  Collection


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f2-poljradiol-79-24: (A) MRI, T2-weighted image. (B) MRI arthrogram, T 1-weighted image. (C) CT arthrogram.

Mentions: CT arthrogram confirmed scapholunate ligament dehiscence (interosseous distance – 4 mm), signs of lunate bone sclerosis with retention of its shape and size as well as the possibility of coexisting triangular fibrocartilage complex damage (Figure 2).


Avascular necrosis of the lunate bone (Kienböck's disease) secondary to scapholunate ligament tear as a consequence of trauma - a case study.

Kulhawik D, Szałaj T, Grabowska M - Pol J Radiol (2014)

(A) MRI, T2-weighted image. (B) MRI arthrogram, T 1-weighted image. (C) CT arthrogram.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3921098&req=5

f2-poljradiol-79-24: (A) MRI, T2-weighted image. (B) MRI arthrogram, T 1-weighted image. (C) CT arthrogram.
Mentions: CT arthrogram confirmed scapholunate ligament dehiscence (interosseous distance – 4 mm), signs of lunate bone sclerosis with retention of its shape and size as well as the possibility of coexisting triangular fibrocartilage complex damage (Figure 2).

Bottom Line: Early diagnosis and treatment can prevent progression of necrotic lesions and bone collapse.Arthro-MRI examination also allows us to identify the underlying ligamentous injury.In cases of traumatic etiology, an additional CT test enables stating the final diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging Diagnostics, Independent Public Clinical Hospital, Otwock, Poland.

ABSTRACT

Background: Avascular necrosis of the lunate bone (Kienböck's disease), is a condition in which lunate bone, loses its blood supply, leading to necrosis of the bone. There is probably no single cause of Kienbock's disease. Its origin may involve multiple factors, such as the blood supply (arteries), blood drainage (veins), and skeletal variations. Trauma, either isolated or repeated, may possibly be a factor in some cases. This case presented with multifactorial etiology.

Case report: In the presented case, a patient with negative ulnar variant had injured her right wrist and presented at an orthopedic clinic due to nonspecific pain 6 months later. An arthro-MRI examination revealed necrosis of the lunate bone, scapholunate ligament tear and coexisting TFCC (triangular fibrocartilage complex) tear.

Conclusions: Early diagnosis and treatment can prevent progression of necrotic lesions and bone collapse. MRI examination seems to be the key diagnostic method in the early stage of the Kienböck's disease with negative x-ray and CT images. Arthro-MRI examination also allows us to identify the underlying ligamentous injury. In cases of traumatic etiology, an additional CT test enables stating the final diagnosis.

No MeSH data available.


Related in: MedlinePlus