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J Wrist Surg 2020; 09(01): 039-043
DOI: 10.1055/s-0039-1688993
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Radiographic and Computed Tomography Correlation of Kienböck's Disease: Is There a Need to Revisit Staging with Improved Imaging?

Arvind Mohan
1   Croydon University Hospital NHS Trust, London, England
,
Richard Knight
2   Upper Limb Unit, Wrightington Hospital, Lancashire, England
,
Hiba Ismail
2   Upper Limb Unit, Wrightington Hospital, Lancashire, England
,
Ian A. Trail
2   Upper Limb Unit, Wrightington Hospital, Lancashire, England
› Author Affiliations Funding None.
Further Information

Publication History

27 March 2019

12 April 2019

Publication Date:
11 December 2019 (online)

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Abstract

Carpal height ratio and ulnar variance on plain X-ray were measured and compared to the width/height ratio of the lunate as measured on a computed tomography (CT) scan in 50 patients with Kienböck's disease. Width/height ratio of the lunate was also measured in a series of 50 controls. No correlation between ulnar variance and fractures was found. Conversely, the correlation between carpal height ratio on X-ray and width/height ratio on a CT scan was statistically significant. Similarly, the correlation between ulnar variance and width/height ratio was statistically significant. We have concluded that width/height ratio while correlating with carpal height is a better measure of lunate collapse. It also appeared that lunate collapse precedes carpal collapse, specifically most if not all lunates have collapsed prior to reduction in carpal height ratio. Finally, while we are unable to conclude the level at which the width/height ratio of lunate becomes unreconstructable, it does appear that in all Litchman stage 3b and most if not all of 3a the shape of the lunate has altered significantly.

Keywords

Kienböck's disease - radiographic - correlation

Note

All authors named were involved in preparing this paper and meet the criteria outlined by the Journal of Wrist Surgery. This article has not been submitted elsewhere and conforms to the submission guidelines.


 

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