Kienbock disease

Discussion:

Kienbock disease is a condition of unknown etiology.

The clinical presentation is chronic wrist pain with no history of trauma.

Plain films form the basis for staging and treatment of Kienbock disease.

Lithcman's modification of Stahl's classification is most widely used and divides the disease into five stages, as follows:

  • stage I: normal radiograph

  • stage II: increased radiodensity of the lunate with a possible decrease of lunate height on the radial side only

  • stage III

    • IIIa: lunate collapse, no scaphoid rotation

    • IIIb: lunate collapse, fixed scaphoid rotation

  • stage IV: Degenerative changes around the lunate. According to the above classification, this patient includes stage II.

  This case demonstrates stage II Stahl's classification of avascular necrosis of the lunate.

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