Erika Nealey MD, Presenter: Nothing to Disclose

Jonelle Marie Petscavage-Thomas MD, MPH, Abstract Co-Author: Consultant, Medical Metrics, Inc

Felix Sze-Kway Chew MD, Abstract Co-Author: Nothing to Disclose

Alice S. Ha MD, Abstract Co-Author: Nothing to Disclose

Kienbock disease, or avascular necrosis of the lunate, is a progressive disease ultimately resulting in collapse, fragmentation, and end-stage arthrosis of the lunate. Symptoms include chronic pain, decreased wrist range of motion, and decreased grip strength. A recent systematic review of various surgical treatments of Kienbock disease showed none with a superior outcome; as such, different treatments remain in current clinical use. This educational exhibit is designed to describe the pre- and post-operative imaging appearances of Kienbock disease, beginning with anatomic antecedents, pathophysiology, stages of disease progression correlated with surgical treatments, normal and abnormal postoperative appearances, and appropriate use of imaging.

1.) Anatomic antecedents 2.) Pathophysiology 3.) Osteonecrosis (Stage 1) -Treatment - casting 4.) Sclerosis (Stage 2) -Treatment in setting of ulnar negative variance --Radial shortening --Capitate shortening -Treatment in setting of ulnar positive variance --Pedicled bone graft --Radial osteotomy --Capitate shortening 5.) Collapse and Fragmentation (Stage 3) -Treatment --Intercarpal arthrodesis --Lunate excision --Proximal row carpectomy 6.) End-Stage Arthrosis (Stage 4) -Treatment --Proximal row carpectomy --Carpal arthrodesis

http://abstract.rsna.org/uploads/2014/14015991/14015991_uwqu.pdf

Nealey, E, Petscavage-Thomas, J, Chew, F, Ha, A, The Luckless Lunate: Pre- and Postoperative Imaging of Kienbock Disease.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015991.html