Kienböck disease is a condition of uncertain etiology that ultimately results in osteonecrosis of the carpal lunate.
Contents - Introduction Indications Relevant Anatomy And Contraindications Workup Treatment Outcome And Prognosis Bibliography
Synonyms and related keywords: avascular necrosis of the lunate, osteonecrosis of the carpal lunate, wrist injury, wrist pain, lunatomalacia, Kienbock disease

Kienbock’s Disease (lunate malacia) is named after Robert Kienbock, who described the disease process in 1910. The cause of the disease is not definitive, but has been associated with ulnar minus variance, as well as other traumatic injury, ranging from repeated compressive strains to a single traumatic fracture. The histologic findings (avascular necrosis) and natural progression of the disease are well established, although treatments vary.

Kienbock's disease aka/or Carpal lunate osteochondrosis
may cause or feature wrist pain
Kienbock's disease: Definition(s) via UMLS....."Osteonecrosis of the lunate."

Notes and illustrations

Wheeless' Textbook of Orthopaedics
Discussion: - self limiting avasulcar necrosis of the navicular; - usually unilateral and affects children, most often boys; - onset is at age 4 in boys and age 5 in girls; - navicular is subjected to repetitive compressive forces during wt bearing which may be a risk factor for AVN; - navicular is last bone in foot to ossify & delayed ossification appears to make the navicular more vulnerable to compressive damage; - compressive forces can occlude the vessels of the soft ossification center redering it avascular;

Kohler first disease aka/or Osteochondrosis of tarsal navicular

Search String allintitle: site:www.ncbi.nlm.nih.gov kohler (disease OR syndrome)
Please note that some authors use the term Second Kohlers or Freiberg-Kohlers or Kohlers II for Osteochondritis of the 2nd metatarsal (usually Freiberg's Disease)

Ramachandran KR, Sasidharan K, Kusumakumary P, Ittiyavirah AK, Krishnakumar AS. Osteochondritis of the tarsal navicular bone (kohler's disease) occurring in a child with acute lymphoblastic leukemia. Indian J Radiol Imaging 1999;9:153-154
Osteochondritis is a disease of one or more epiphyses beginning as a necrosis followed by healing. Osteonecrosis is commonly encountered in children treated for hematological malignancies, especially with a steroid-containing regime. However the incidence is much less as compared to avascular necrosis. We report a case of osteochondritis of the tarsal navicular bone in a seven-year old child undergoing treatment for acute lymphoblastic leukemia (ALL) in our institution, with a steroid-containing regime.

1937 JBJS Paper
This syndrome occurs predominantly in male children between the ages of two and one-half and seven and one-half years, and is manifested by pain, a limp, swelling, and localized tenderness in the foot. It is more frequently unilateral than bilateral and has a characteristic x-ray picture which is unrelated to duration of symptoms or to treatment. Complete regeneration of the involved bone takes place in an average of two and three-fourths years, and a normal foot is the usual end result. It is suggested by this study that the retarded development of the osseous nucleus of the scaphoid may alter its density, outline, and configuration, so as to simulate the picture of Köhler's disease.

NAVICULAR OSTEONECROSIS: KOHLER'S DISEASE Contributed by: Residents Kaiser, Resident, Kaiser Permanente, California, USA. Patient: 5 year old male

Xray Illustration of a case and 10 references (to 1995)

Definition - Inflammation of bone and cartilage Osteochondritis may be caused by or feature of the following - Miscellaneous syndromes Blount's disease Freiberg's disease Juvenile osteochondrosis of head of femur Juvenile osteochondrosis of spine Kienbock's disease Kohler first disease Sever's disease Sinding Larsen-Johannson disease Orthopaedic conditions Aseptic necrosis of bone Humerus juvenile osteochondritis Iselin's disease Osgood-Schlatter's disease Osteochondritis dissecans may cause or feature - Arthropathy Kyphosis may be a risk factor for - Osteoarthritis

ARRS Goldminer Search

degeneration followed by reossification of one or more ossification centers in children Legg-Calve-Perthes disease (capital femoral epiphysis) Kohler disease (tarsal navicular) Osgood-Schlatter disease (tibial tuberosity) Scheuermann disease (vertebral ring epiphyses) Freiberg infraction (metatarsal head) Sever disease (apophysis of os calcis) osteochondritis dissecans

OSTEOCHONDROSIS DEFORMANS TIBIAE, FAMILIAL INFANTILE TYPE Alternative titles; symbols TIBIA VARA BLOUNT DISEASE