Kienbock's disease

Title

Other Names:

Kienbock disease; Bilateral Kienbock's disease

Categories:

Musculoskeletal Diseases

Summary Summary

Kienbock's disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist (the lunate). If blood supply to a bone stops, the bone can die; this is known as osteonecrosis. Affected people may first think they have a sprained wrist and may have experienced trauma to the wrist, which can disrupt the blood flow to the lunate. As the disease progresses, signs and symptoms may include a painful and/or swollen wrist; stiffness; decreased grip strength; tenderness directly over the bone; and pain or difficulty in turning the hand upward. The underlying cause of Kienbock's disease is unknown. Treatment aims to relieve the pressure on the bone and restore blood flow within the bone. Surgery may be recommended.^[1]

Last updated: 2/10/2015

Symptoms Symptoms

Kienbock's disease most commonly affects men between the ages of 20 and 40 years, but it affects women as well. Most affected people report a history of trauma to the wrist. Symptoms can vary depending on the stage of the condition, but usually include pain that is localized to the affected area, decreased motion, swelling, and weakness in the affected hand. Rarely, the condition may occur in both hands.^[2]

Last updated: 2/10/2015

The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below.

Signs and Symptoms	Approximate number of patients (when available)
Abnormality of the wrist	90%
Arthralgia	90%
Aseptic necrosis	90%
Bone pain	90%
Limitation of joint mobility	90%
Osteoarthritis	50%

Last updated: 9/1/2016

Inheritance Inheritance

There is currently no evidence that Kienbock's disease is inherited. However, the cause of Kienbock's disease is not known. It is possible that unidentified genetic factors contribute to the development of the condition.^[3]

Last updated: 2/10/2015

Treatment Treatment

The primary means of nonsurgical treatment of Kienbock's disease involve immobilization and anti-inflammatory medications.^[4] The wrist may be immobilized through splinting or casting over a period of two to three weeks. Anti-inflammatory medications, such as aspirin or ibuprofen, can help to relieve pain and reduce swelling. If the pain continues after these conservative treatments, your physician may refer you to an orthopaedic or hand surgeon for further evaluation.^[1]

Last updated: 8/16/2011

Prognosis Prognosis

The long-term outlook (prognosis) for people with Kienbock's disease is hard to predict and the natural history of the disease is not well understood.^[5] Kienbock's disease varies considerably in both severity and rate of progression.^[6] Some people with Kienbock's disease have no symptoms, while others have variable symptoms ranging from mild and intermittent, to severe and debilitating. Furthermore, the severity of the condition as seen on imaging studies does not always correlate with the degree of symptoms a person has.^[5]

Each person's response to treatment depends on the degree of damage to the lunate and surrounding wrist bones. Some people may need more than one procedure if the disease continues to progress.^[6] It has been suggested that people who are diagnosed and treated later in life tend not to do as well as those diagnosed and treated earlier.^[7] In general, people with Kienbock's disease should not expect to return to normal wrist function, even after treatment. However, treatment gives the greatest opportunity for long-term preservation of function and pain relief.^[6]

Last updated: 2/12/2015

Research Research

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

Orphanet lists European clinical trials, research studies, and patient registries enrolling people with this condition.

Organizations Organizations

Nonprofit support and advocacy groups bring together patients, families, medical professionals, and researchers. These groups often raise awareness, provide support, and develop patient-centered information. Many are the driving force behind research for better treatments and possible cures. They can direct people to research, resources, and services. Many groups also have experts who serve as medical advisors. Visit their website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD. Suggest an organization to add.

Organizations Supporting this Disease

National Osteonecrosis Foundation
Good Samaritan Professional Building
Suite 201
5601 Loch Raven Blvd.
Baltimore, MD 21239
Telephone: 410-532-5985
Fax: 410-532-5908
Website: http://www.nonf.org/index.html

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

The American Academy of Orthopaedic Surgeons has information on Kienbock's disease. Click on the link above to view this information page.
MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
The Merck Manual provides information on this condition for patients and caregivers.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases. Click on the link to view information on this topic.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Kienbock's disease. Click on the link to view a sample search on this topic.

News & Events News & Events

News

Young Investigator Initiative Career Development and Grant Mentoring Program
June 21, 2016

Related Diseases Related Diseases

The following diseases are related to Kienbock's disease. If you have a question about any of these diseases, you can contact GARD.

Osteochondrosis

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How long does it take for this disease to develop? See answer
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References References

Kienbock's Disease. American Academy of Orthopaedic Surgeons. October 2007; http://orthoinfo.aaos.org/topic.cfm?topic=a00017. Accessed 8/16/2011.
Cross D, Matullo KS. Kienböck disease. Orthop Clin North Am. January, 2014; 45(1):141-152. Accessed 2/10/2015.
Stahl S et al., . An international opinion research survey of the etiology, diagnosis, therapy and outcome of Kienböck’s disease (KD). Chirurgie de la main . 31 (2012) 128–137; http://www.ncbi.nlm.nih.gov/pubmed/22609038. Accessed 5/13/2013.
Divelbiss BJ, Baratz ME. Kienbock Disease. eMedicine. 2010; http://emedicine.medscape.com/article/1241882-overview. Accessed 8/16/2011.
Lutsky K, Beredjiklian PK.. Kienbock disease. J Hand Surg Am. September, 2012; 37(9):1942-1952.
Charles D. Jennings. Kienböck's Disease. AAOS. May, 2012; http://orthoinfo.aaos.org/topic.cfm?topic=a00017.
Martin GR, Squire D. Long-term outcomes for Kienböck's disease. Hand (N Y). March, 2013; 8(1):23-26.