Correlation of clinical and radiographic findings in Kienböck's disease

Radiographic and clinical findings were reviewed in 50 patients with Kienböck's disease. In 40 patients the clinical and radiographic findings were complete enough to allow correlation of findings. Measurements were made from radiographs in an attempt to quantify the anatomic substrate of Kienböck's disease and to determine which radiographic measurements might be helpful in predicting the course and prognosis of the disease. The measurements included ulnar variance, radial slope, carpal index, carpal angle, combined cortical thickness, optical density, radial slant, scapho-lunate angle, lunate deformation quotient, and the radiographic stages modified from Stahl. These measurements were correlated with patient's history, age at onset of disease, range of motion, and grip strength. Relevant anatomic factors were ulnar variance and the radial slope. The best radiographic features for correlation with loss of motion and grip strength were the lunate deformation quotient and, to a lesser extent, the carpal index. None of the radiographic measurements were very strongly correlated with the clinical findings.