Osteonecrosis is defined as the death of bone due to interruption of the blood supply to the bone. Kienböck’s disease is osteonecrosis of lunate bone as a result of heavy repetitive loading on wrist. We planned to present a 39-year-old patient having pain, swelling and limitation of range of motion (ROM) in right wrist, because Kienböck’s disease should be into account in differential diagnosis of such patients. X-ray of the right wrist of patient demonstrated sclerosis, cystic appearance and irregularity in lunate bone. Irregularities, loss of volume and diffuse low-intensity appearance were observed in lunate bone on T1-weighted MR images. T2-weighted fat-saturated MR images demonstrated diffuse hyperintensity in the same areas which is suggested bone-marrow edema. These findings were determined as the changes with related osteonecrosis of the lunate bone. Resting splint and antiinflammatory treatment were given to the patient. The patient was consulted to the department of orthopedics and traumatology. Patient refused operation. Pain, swelling and limitation of ROM of the patients improved after 3 weeks. In conclusion, Kienböck’s disease should be into account in the differential diagnosis of patients having pain, swelling and limitation of ROM in wrist. (From the World of Osteoporosis 2009;15:26-8)Key words: Osteonecrosis, Kienböck’s disease
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Giris
Osteonekroz, kemige olan kan akiminin kesilmesinden dolayi kemigin ölümü olarak tanimlanir. Travma, alkolizm, gebelik, obesite, hemoglobinopati ve kortikosteroid kullanimi osteonekroz sebepleri arasinda yer almaktadir. Genellikle karpal, tarsal kemiklerde ve büyük kemiklerin apofiz ve epifizlerinde olmak üzere vücutta 50’den fazla bölgede görülebilir (1). Olasi osteonekroz komplikasyonlari sekonder dejeneratif eklem hastaligi ve kistik yada sarkomatöz transformasyondur (2).Kienböck hastaligi, el bileginin hiperekstansiyon zorlamasi sonucu gelisen lunat kemigin osteonekrozudur (3). Kronik travma sonucu sag el bileginde lunat kemikte osteonekroz gelisen erkek hastayi, el ve elbileginde agri, sislik ve hareket kisitliligina neden olan hastaliklarin ayirici tanisinda düsünülmesi gerektiginden dolayi sunmayi planladik.
