Is osteonecrosis of the lunate bone an underestimated feature of systemic sclerosis? A case series of nine patients and review of literature

Frerix, Marc; Kröger, Kai; Szalay, Gabor; Müller‐Ladner, Ulf; Tarner, Ingo H.

doi:10.1016/j.semarthrit.2015.07.010

Cited by 15 publications

(5 citation statements)

References 20 publications

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“…Primary arterial (Raynaud disease and systemic sclerosis) and embolic disorders (atrial fibrillation) 22 are rarely associated with KD. 23,24 Conditions which increase the fat content in bone marrow (e.g., alcohol and Gaucher disease), are rarely associated with KD. 22 However, when the intraosseous fat is ischemic, it becomes edematous and potentiates the "compartment syndrome" within the lunate.…”

Section: Compartment Syndrome Of Bonementioning

confidence: 99%

The Etiology and Pathogenesis of Kienböck Disease

et al. 2016

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Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "atrisk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow. The increased osseous compartment pressure further potentiates the venous obstruction, producing avascular necrosis. If the fracture remains localized, it can heal or settle into a stable configuration, so that the wrist remains functional. Fractures of the subchondral bone plate produce irregularity of the lunate articular surfaces and secondary "kissing lesions" of the lunate facet and capitate, and subsequent degeneration. The lunate collapses when the fracture is comminuted, or there is disruption of the spanning trabeculae or a coronal fracture. The secondary effect of the lunate collapse is proximal migration of the capitate between the volar and dorsal fragments, producing collapse of the entire central column. The proximal carpal row is now unstable, and is similar to scapholunate instability, where the capitate migrates between the scaphoid and lunate. The scaphoid is forced into flexion by the trapezium, however, degeneration of the scaphoid and scaphoid facet only occurs in late disease or following failed surgery. In Kienböck disease, the secondary effects of the collapsing lunate are a "compromised" wrist, including: deformity and collapse of the central column, degeneration of the central column (perilunate) articulations, proximal row instability (i.e., between the central and radial columns), and degeneration of the radial column.

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Section: Compartment Syndrome Of Bonementioning

confidence: 99%

The Etiology and Pathogenesis of Kienböck Disease

et al. 2016

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“…If there is a systemic cause, such as systemic lupus erythematosus (SLE), multifocal infarctions of the foot and ankle can occur [2,5,6]. There are several case reports that describe an association between SSc and AVN, which is most commonly observed in the hip [7][8][9] and lunate bone [10][11][12]. However, only two cases of SSc with AVN of the foot are briefly mentioned in literature [13,14].…”

Section: Discussionmentioning

confidence: 99%

Avascular Necrosis of the Foot and Ankle in a Patient with Systemic Sclerosis: A Case Based Review

Wastyn

Leys²,

Michels³

et al. 2021

Sovremennaâ revmatologiâ

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This review describes a case of atraumatic avascular necrosis in the foot and ankle in a patient with systemic sclerosis who did not receive corticosteroid therapy. Both avascular necrosis and systemic sclerosis are uncommon disease entities. This case demonstrates that vasculitis and secondary vasoconstriction in the pathogenesis of systemic sclerosis are important risk factors for the development of avascular necrosis of the foot and ankle. Therefore, if these patients develop chronic foot and ankle pain, avascular necrosis should be included in the differential diagnosis, even if they do not receive corticosteroids. For the diagnosis and follow-up of avascular necrosis MRI remains the gold standard. Thus, MRI should be used to diagnose avascular necrosis in an early stage. Level of Clinical Evidence: 4.

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“…Depending on the degree of damage there are several surgical options available: Revascularization, capitates-shortening osteotomy, joint leveling, metaphyseal core decompression, proximal row carpectomy, fusion, and arthroplasty (Frerix et al, 2016;Hong et al, 2019;Kim et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Kienbock’s Disease: A Case Study

Burkow-Heikkinen¹,

Morency²

2020

FMCR

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Kienbock's disease is a relatively rare disorder where the blood supply to one of the small bones in the wrist is interrupted. The affected bone, the lunate, is one of eight small carpal bones that is in the middle at the base of the wrist and is responsible for wrist movement. This case study examines an otherwise healthy white 71 year old female with extreme wrist pain, initially diagnosed by the provider as tiny ganglion cysts in the ulnar tissue but later appropriately diagnose Kienbock's left wrist with ulnar minus. This case study will study the care of the wrist using a 940nm near-infrared light emitting diode.Background: There is no cure for Kienbock's disease, but prompt treatment can help preserve wrist function and relieve pain. Kienbock's disease progresses through four stages; loss of blood flow, sclerosis of bone, breakdown of lunate bone, and finally the breakdown of the remaining bones of the hand (Allan et al., 2001). The rate of progression is varied from case to case. Objective:To evaluate the effects of the near infrared light emitting diode on inflammation and bone healing. Materials and method:This article investigates the role of near infrared light emitting diode on the sclerosis of the lunate carpal bone, stage one of Kienbock's disease.A review of books, journals, PubMed, and physician notes Discussion: Using the near infrared light emitting diode (NIR LED), healing rate has increased, a decrease in inflammation, bone regeneration, and pain has minimized. The NIR LED gallium arsenide can be used as an adjunctive therapy for reduction for this progressive disease.

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Is osteonecrosis of the lunate bone an underestimated feature of systemic sclerosis? A case series of nine patients and review of literature

Cited by 15 publications

References 20 publications

The Etiology and Pathogenesis of Kienböck Disease

The Etiology and Pathogenesis of Kienböck Disease

Avascular Necrosis of the Foot and Ankle in a Patient with Systemic Sclerosis: A Case Based Review

Kienbock’s Disease: A Case Study

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