Kienböck's disease in a 32-year-old female: a case report

Kienböck's disease, or avascular necrosis of the lunate bone, is a rare condition with an estimated prevalence of 7 per 100 000 individuals. It typically affects males aged 20-40 years and often presents with wrist pain, decreased grip strength, and reduced mobility. Early diagnosis and appropriate management are crucial to prevent long-term joint destruction.

We present a case of a 32-year-old female with chronic right wrist pain and reduced grip strength for 2 years. Examination revealed tenderness over the lunate and decreased wrist motion. Imaging confirmed sclerosis and avascular necrosis of the lunate (Stage II Lichtman classification). Conservative management with NSAIDs and physical therapy was initiated, followed by radial shortening osteotomy.

Kienböck's disease diagnosis relies on radiography, MRI, and occasionally bone scintigraphy. Early stages benefit from conservative management, while surgical intervention is recommended for more advanced cases. Radial shortening osteotomy has shown excellent outcomes in pain relief and functional recovery. Our patient showed significant improvement in pain and wrist mobility after surgery and rehabilitation.

This case highlights the importance of early diagnosis and stage-specific management of Kienböck's disease. Combining non-surgical and surgical approaches can achieve favourable outcomes. Longer follow-up is necessary to monitor for potential late complications.