Basic imaging and differential diagnosis of kienböck’s disease

Lee Wang, Michael B. Zlatkin, Paul Clifford

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Imaging serves an important role in the diagnosis and classification of Kienböck’s disease. The four-stage system proposed by Lichtman et al. in 1977 is an imaging-based classification system, which has significant implications for treatment planning. Whereas the initially proposed Lichtman classification was based primarily on radiographical osseous findings, advancements in the understanding of computed tomography (CT) and magnetic resonance imaging (MRI) features of Kienböck’s disease have allowed incorporation of these two modalities into the classification system. The appearance of imaging features of Kienböck’s disease mirrors the natural course of the disease-progressing from marrow edema of the lunate (stage I) to trabecular sclerosis (stage II), to lunate collapse (stage III), and ultimately to secondary degenerative changes of the wrist. MRI has proven to be useful for the detection of early Kienböck’s disease, which is frequently not demonstrated on radiography and CT. It is also useful for assessing and staging the articular cartilage involvement and monitoring the revascularization and response to treatment. This chapter discusses the diagnostic criteria and imaging features of Kienböck’s disease. It utilizes the Lichtman classification as a framework in this description. A comparison of the utility of the various imaging modalities and a discussion of the differential diagnoses for Kienböck’s disease are also included.

Original languageEnglish (US)
Title of host publicationKienbock's Disease
Subtitle of host publicationAdvances in Diagnosis and Treatment
PublisherSpringer International Publishing
Pages111-120
Number of pages10
ISBN (Electronic)9783319342269
ISBN (Print)9783319342245
DOIs
StatePublished - Jan 1 2016

Keywords

  • Differential diagnosis
  • Kienböck’s disease
  • Lunatomalacia
  • MRI
  • Radiography
  • Wrist and hand

ASJC Scopus subject areas

  • Medicine(all)

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