Correlation of Histopathology With Magnetic Resonance Imaging in Kienböck Disease

Abstract

Proton density-weighted MRIs accurately reflect the vascular status of the lunate and may help plan treatment on a case-by-case basis.

A new treatment strategy for Kienböck’s disease: combination of bone marrow transfusion, low-intensity pulsed ultrasound therapy, and external fixation

“…Kienböck’s disease is denoted an avascular necrosis because blood vessels are usually absent. In the lunates in our other study, the trabecular bone structures were segmented and fatty marrow was absent, which potentially allows the formation of fibrous granulation tissues, albeit in the presence of blood vessels [21]. Moreover, nutrient vessels enter the lunate in a distal-to-proximal direction via the palmar and dorsal horns and build an intraosseous vascular network [30].…”

“…In general, PDW images of normal lunates exhibit high signal intensities, whereas FFE images exhibit intermediate intensities. In comparison, PDW images of the necrotic lunate demonstrate lower signal intensities, while FFE images exhibit higher or lower intensities [21]. We evaluated all eight slices.…”

Magnetic Resonance Imaging of the Hand and Wrist: Techniques and Spectrum of Disease

“…In the earliest stage of the disease, conventional radiographs are normal, and changes in the lunate are appreciated only by MRI 1,2,34-36 . T1-weighted images reveal diffusely low signal intensity throughout the bone [35][36][37] (Fig. 11).…”

“…11). T2-weighted images have been reported to correlate with prognosis 37 , with low signal intensity corresponding to marrow fibrosis and the presence of increased signal intensity being directly proportional to lunate vascularization 35,36 . In the second stage, sclerosis is apparent on conventional radiographs.…”

Kienbock Disease, a Tertiary Care Experience from the Developing World

“…Kienbock's disease is a form of osteonecrosis characteristically affecting the lunate, first described in 1910 by Robert Kienbock who identified the changes in the proximal portion of the lunate and affecting the radiolunate articulation [2]. It is characterized by lunate sclerosis, cystic changes, fragmentation and articular surface collapse on plain radiograph [3,4].…”