What Is Kienböck’s Disease?
Kienböck’s disease (avascular necrosis of the lunate) develops when the lunate bone, the central bone in the wrist, loses its blood supply and begins to deteriorate. The lunate is one of eight bones that make up the base of the hand. Located in the center of the wrist, this bone provides support for the joint and works with the forearm bones (radius and ulna) to help with your wrist’s ability to move. When the lunate is damaged, this can lead to stiffness and pain, as well as eventual arthritis. Kienböck’s disease is a condition that slowly progresses over time, but with proper treatment, symptoms can be treated and function can be maintained.
Signs & Symptoms
Individuals suffering from Kienböck’s disease will typically notice a combination of the following symptoms:
- Pain in the wrist
- Tenderness at the lunate bone
- Swelling
- Stiffness of the wrist
The condition does not usually affect both wrists. Since Kienböck’s disease worsens very slowly, many people go months, if not years, before seeing a doctor about their symptoms. After time has passed, they may also develop wrist arthritis.
Causes
Multiple factors can cause Kienböck’s disease to develop. This can include:
- Irregular bone structure, such as an abnormally shaped lunate or uneven radius and ulna bones
- Trauma to the area
- Other medical conditions that affect blood supply
Kienböck’s disease is most common in men 20 to 40 years old. It has also been found more often in those with conditions like lupus, cerebral palsy, and sickle cell anemia.
Treatment
Diagnosing Kienböck’s disease can usually be done after reviewing your medical history, carrying out a physical exam, and taking X-rays. If the disease is in its early stages, diagnosis can be more complicated since X-rays may not show the bone degeneration. As a result, an MRI may be necessary to look at the blood supply of the bone.
Treatment for Kienböck’s disease is intended to reduce pain and improve function affected by the condition. The best treatment for a patient will depend on the stage of their disease. If caught early on, our reconstructive hand surgeons may recommend simply monitoring the disease or immobilizing the area. If the condition is more severe, surgery is usually the best treatment. Hand therapy can also be useful for limiting the effect Kienböck’s disease has on the wrist’s function.
