Kienböck's disease
(Redirected from Bilateral Kienbock's disease)
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Kienböck's disease | |
---|---|
Synonyms | Lunatomalacia |
Pronounce | N/A |
Specialty | Orthopedic surgery |
Symptoms | Wrist pain, stiffness, swelling |
Complications | Osteoarthritis, loss of wrist function |
Onset | Typically between ages 20 and 40 |
Duration | Chronic |
Types | N/A |
Causes | Disruption of blood supply to the lunate bone |
Risks | Trauma, repetitive stress, anatomical variations |
Diagnosis | X-ray, MRI |
Differential diagnosis | Scaphoid fracture, Wrist sprain, Rheumatoid arthritis |
Prevention | N/A |
Treatment | Immobilization, Physical therapy, Surgery |
Medication | NSAIDs |
Prognosis | Variable, depends on stage and treatment |
Frequency | Rare |
Deaths | N/A |
Kienböck's disease is a condition that affects the lunate bone in the wrist. It is characterized by the progressive collapse of the lunate bone due to a disruption in its blood supply, leading to avascular necrosis. This condition can result in chronic pain and limited wrist function.
Pathophysiology
Kienböck's disease occurs when the blood supply to the lunate bone is compromised. The exact cause of this disruption is not well understood, but it is believed to be related to repetitive trauma, anatomical variations, or other underlying conditions that affect blood flow. The lack of blood supply leads to the death of bone tissue, causing the lunate to collapse and deteriorate over time.
Stages
Kienböck's disease is typically classified into four stages based on radiographic findings:
- Stage I: Early changes with possible fracture lines but no collapse.
- Stage II: Sclerosis and fragmentation of the lunate without collapse.
- Stage III: Collapse of the lunate with or without carpal instability.
- Stage IV: Advanced collapse with secondary osteoarthritis of the wrist.
Symptoms
The primary symptoms of Kienböck's disease include:
- Chronic wrist pain, particularly over the lunate bone.
- Swelling and tenderness in the wrist.
- Decreased range of motion and grip strength.
- Stiffness and difficulty performing daily activities.
Diagnosis
Diagnosis of Kienböck's disease typically involves a combination of clinical evaluation and imaging studies. X-rays, MRI, and CT scans are commonly used to assess the condition of the lunate bone and the extent of the disease.
Treatment
Treatment options for Kienböck's disease vary depending on the stage of the disease and the severity of symptoms. They may include:
- Non-surgical treatments: Immobilization with a cast or splint, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy.
- Surgical treatments: Procedures such as revascularization, joint leveling, lunate excision, or wrist fusion may be considered in more advanced cases.
Prognosis
The prognosis for Kienböck's disease varies. Early diagnosis and treatment can help manage symptoms and slow the progression of the disease. However, in advanced stages, the condition may lead to significant wrist dysfunction and chronic pain.
See also
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Contributors: Prab R. Tumpati, MD