Bilateral Kienbock's Disease Concomitant with Bilateral Legg–Calvé–Perthes Disease: A Case Report

Wollstein, Adi; Tantawi, Diya; Wollstein, Ronit

doi:10.1007/s11552-012-9465-6

Cited by 6 publications

(7 citation statements)

References 7 publications

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“…Unlike femoral head osteonecrosis, there are no apparent risk factors defined for bilateral Kienböck’s disease due to the rarity of its involvement in systemic diseases. However, there are few reports of bilateral Kienböck’s disease in SLE,2 scleroderma4 and Legg-Calvé-Perthes disease 16. The present case of bilateral Kienböck’s disease combination with gout in the absence of ulnar-negative variance indicates a relationship between them.…”

Section: Discussionmentioning

confidence: 48%

Bilateral Kienböck’s disease concomitant with gouty arthritis

2020

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A 38-year-old man presented with a 2-month history of pain and stiffness in the bilateral wrist. The pain in right wrist was disabling and severe enough to restrict the daily life activities. After the evaluation of clinical and radiological features, the patient was diagnosed with Kienböck’s disease Lichtman stage IIIB in the right wrist and stage IIIA in the left wrist. Routine laboratory investigations revealed a serum uric acid 9.27 mg/dL. Lunate excision and scaphocapitate fusion were done in the right wrist after discussing with the patient. The histopathological examinations of tophi in synovial tissue were negatively birefringent under polarised light microscopy. It confirmed the diagnoses of gout. Febuxostat was started postoperatively. The patient returned to work at the end of 5 months. There was no recurrence of symptoms and radiological signs of arthritis at the end of 1 year.

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Section: Discussionmentioning

confidence: 48%

Bilateral Kienböck’s disease concomitant with gouty arthritis

2020

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“…None of the children with bilateral disease complained of pain in the wrist or ankle suggestive of a more generalized osteochondritis syndrome. 15,16…”

Section: Resultsmentioning

confidence: 99%

Radiologic Outcomes of Bilateral and Unilateral Perthes Disease: A Comparative Cohort Study

Singh

Guddattu

Shah

2021

Journal of Pediatric Orthopaedics

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Introduction: This study was undertaken to compare the radiologic outcomes of bilateral and unilateral Perthes disease and also to evaluate the outcome of synchronous and metachronous bilateral Perthes disease. Methods: Of 353 children with Perthes disease followed up from presentation to healing during the last 10 years, 37 had bilateral involvement (11 synchronous and 26 metachronous onset). The radiologic outcomes of each hip of children with bilateral disease were compared with outcomes of 148 children with unilateral disease who were matched for age, sex, and treatment. Children with unilateral or bilateral diseases were treated with a proximal femoral varus derotation osteotomy if they fulfilled the criteria for surgery. The primary outcome measure was the shape of the femoral head at healing assessed by the Sphericity Deviation Score (SDS). Results: The children with bilateral disease were younger than those with unilateral disease (6.2 vs. 7.03 y; P < 0.001), and they had a longer duration of the disease. All other characteristics of bilateral and unilateral cases were similar. The SDS values of unilateral and bilateral disease were comparable, as were the SDS of synchronous and metachronous bilateral disease. The effect of early surgery on the evolution of the disease in bilateral cases was similar to that reported in unilateral disease. The age of onset of the disease alone influenced the SDS in bilateral cases. Conclusion:The age at onset of the bilateral disease is lower, the duration of the disease longer than that of unilateral disease, but the disease outcome is similar.

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“…While a clear association has yet to be reported in any large series, a recently case of bilateral Kienbock's disease, bilateral Legg-Calve-Perthes disease and a history of transient ischemic attack in a 35 year old male, has been reported. 14 In a case report published by Rostom et al, a 50-year-old female with antiphospholipid antibody syndrome developed bilateral osteonecrosis of the hips and lunate. 2 This unusual presentation of multifocal osteonecrosis is similar to what was seen in our patient with Factor V Leiden thrombophilia.…”

Section: Discussionmentioning

confidence: 98%

“…1,3,5,12 Other studies have failed to find any correlation between hypercoagulable states and the development of osteonecrosis. 10,11,13,14 Here we present a case of an 18-year-old boy with attention deficit hyperactivity disorder (ADHD) and Asperger syndrome, who developed bilateral Legg-Calve-Perthes disease and Kienbock's disease (avascular necrosis of the lunate) of the right wrist. The finding of multifocal osteonecrosis prompted testing for hypercoagulability that revealed Factor V Leiden thrombophilia.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Legg-Calve-Perthes Disease and Kienbock’s Disease in a Child With Factor V Leiden Thrombophilia

Baltzer

Riester

Moran

2016

Hand (New York, N,Y.)

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The etiology of multifocal osteonecrosis is not definitively known; however, hypercoagulable state is a very plausible cause. We present an unusual case of a 12-year-old boy with a history of Legg-Calve-Perthes disease presenting with right wrist pain who was subsequently diagnosed with Kienbock's disease. The finding of multifocal osteonecrosis prompted testing for a hypercoagulable state that was positive for Factor V Leiden thrombophilia. A thorough literature review using Medline database was conducted to investigate associations between inherited hypercoagulable states and multifocal osteonecrosis. Our literature review identified 2 similar cases of multifocal osteonecrosis associated with a hypercoagulable disorder in adult patients. There were no reports among the pediatric patient population. Meta-analysis has demonstrated a potential link between Legg-Calve-Perthes disease and Factor V Leiden thrombophilia. This study offers further evidence to support the theory that multifocal osteonecrosis may be linked to a hypercoagulable state. Patients presenting with multifocal osteonecrosis should undergo screening for hypercoagulable states. Further investigation is needed to ascertain the potential benefit of prophylactic anticoagulation in patients with a known hypercoagulable state and multifocal osteonecrosis.

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Bilateral Kienbock's Disease Concomitant with Bilateral Legg–Calvé–Perthes Disease: A Case Report

Cited by 6 publications

References 7 publications

Bilateral Kienböck’s disease concomitant with gouty arthritis

Bilateral Kienböck’s disease concomitant with gouty arthritis

Radiologic Outcomes of Bilateral and Unilateral Perthes Disease: A Comparative Cohort Study

Bilateral Legg-Calve-Perthes Disease and Kienbock’s Disease in a Child With Factor V Leiden Thrombophilia

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