Progressive avascular necrosis of lunate
Classic history and presentation: This presents as insidious, progressive wrist pain with a history of trauma but negative x-rays in the past.
- Age – This is most common in men between the ages of 20 and 40 years.
- Sex / gender – Male predominance.
- Ulnar negative wrist variance, which leads to increased radial-lunate contact stress
- Decreased radial inclination
- Repetitive trauma
- I: Changes on MRI only
- II: Sclerotic changes in the lunate
- IIIA: Collapse of lunate with NO scaphoid rotation
- IIIB: Collapse of lunate with fixed scaphoid rotation
- IV: Degenerative changes seen in the intercarpal joints
- 0-4 based on the number of articular surfaces that are involved and are "nonfunctional"
M87.039 – Idiopathic aseptic necrosis of unspecified carpus
787484007 – Progressive avascular necrosis of lunate
- Radius / ulna (wrist) fracture
- Wrist sprain
- Scaphoid (or other carpal bone) fracture
- Triangular fibrocartilage complex tear
- Ulnar impaction syndrome
- Ganglion cyst of wrist
- Osteoid osteoma
- Fractures, especially of the scaphoid.
- Kienbock disease is rare and is often a diagnosis of exclusion in the early stages.