In this retrospective study on Kienböck's disease, a comparison was made between 21 cases operated on by various techniques and 22 cases treated conservatively, with a mean follow-up of 65 months. Operative management of the disease did not show any superiority over conservative treatment. Moreover, surgery was responsible for a loss of mobility of 24%, and for a change in social activities in about a quarter of the patients, while grip strength was only slightly improved. Surgical indications for Kienböck's disease should be carefully considered, keeping in mind their side-effects, and the relative benignity in some cases of the natural course of the disease.

We report the case of a patient admitted to our intensive care unit in the course of a septic shock, secondary to cholangitis. After rapid hemodynamic stabilization, antibiotherapy, and endoscopic extraction of bile ducts stones, she appeared to have developed flaccid paraplegia. The suspected diagnosis of medullar ischemia was confirmed by typical MRI findings. This case stresses the potential pathogenic role of hypotension in medullar ischemia and the place of magnetic resonance imaging (MRI) as a reliable diagnostic tool.

No abstract