Kienböck’s Disease

Kienböck's Disease is a rare osteopathic disease in which the blood supply to one of the small bones in the wrist (the lunate) is interrupted resulting in a lack of nourishment to this bone. Without this nourishment, the bone starts to slowly die. While the cause of Kienböck's Disease is not yet known, many with the disease at first believe that they have a sprained wrist given that the symptoms and even cause of onset may be similar. The symptoms, at least at the beginning of the disease, are very similar including pain and a limited range of movement. Often times those with Kienböck's have, also, recently sustained an injury to the wrist. As the disease progresses and the symptoms become worse, a person will notice a painful and swollen wrist, a limited range of motion in the wrist, decreased grip strength in the hand, tenderness directly over the affected bone, and pain or difficulty in turning the hand upwards.
 
Most people have two sources of blood supply to the lunate but in those rare cases where a person has only one, Kienböck's Disease is more common. Most people do not catch Kienböck's in its first stage—due to the similarity in mild symptoms of a wrist sprain. However, in stage two, as the lunate bone begins to harden as a result of lack of blood flow, the disease becomes easier to diagnose. Your doctor should be able to see, with the aid of an X-Ray, MRI, and/or CT scan, to progression of the disease and may be able to offer a more accurate diagnosis. In the second stage, wrist pain, swelling, and tenderness are the most common symptoms. In stage 3, the dead bone begins to collapse and break into several pieces. As this occurs, the patient may feel increasing pain, a weakened grip of the hand, and limited motion. Finally, in stage 4, the surface of the adjoining wrist bones are affected by the injury to the lunate bone. This can result in arthritis of the wrist, additional pain, and even more decreased range of motion in the wrist.
 
While there is no cure for Kienböck's Disease, there are several surgical and non-surgical treatment options. Generally these treatment courses are designed to relieve pressure on the lunate and to restore blood flow to the bone. The wrist can be splinted or casted for several weeks and the patient given anti-inflammatory medication to reduce pain and swelling. If this doesn’t help, the patient is then referred to surgical options for treatment of advanced Kienböck's.