Radiologic diagnosis of lunate necrosis

Abstract

In the literature little is to be found concerning diagnosis and differential diagnosis of Kienböck's disease. Because of technical development in radiological imaging, we now possess very detailed pictures. However, there are many radiological findings within the lunate bone, which can be misinterpreted as Kienböck's disease. Pathological findings of the lunate bone are demonstrated, which are not Kienböck's disease. These findings were compared to different stages of Kienböck's disease and identified. The early stages of Kienböck's disease show changes especially in the MRI, which are very similar to acute bone bruise, ulnar impaction syndrome, synovialitis or gout. Vessel tubes or an intraosseous ganglion can be mistaken for Kienböck's disease. In the late stages of Kienböck's disease, it can be difficult to differentiate this from pseudarthrosis of the lunate bone. The differentiation between Kienböck's disease and other pathological findings is at times very difficult--even with MRI. However, sometimes diagnosis can only be verified by MRI. We therefore suggest that Kienböck's disease must be correctly diagnosed with help of the MRI before commencing with any therapeutic steps.