A rare osteonecrosis Kienböck's disease potentially linked to COVID-19: a case report

Kienböck's disease (KD), an avascular necrosis of the lunate bone, is a rare and progressive condition that may lead to chronic wrist pain and functional limitation. While avascular necrosis associated with COVID-19 has been reported in other skeletal sites, involvement of the lunate bone has not previously been reported. This case adds novel evidence that suggests a potential association between COVID-19 and Kienböck's disease. To demonstrate this potential association, this paper reports a case of Kienböck's disease developing following COVID-19 infection in a 50-year-old woman who was hospitalized in August 2020 with PCR-confirmed COVID-19 pneumonia and bilateral ground-glass opacities on chest CT. She had no prior corticosteroid exposure or comorbidities. Approximately 12 weeks after recovery, she developed progressive left wrist pain without any history of trauma. Subsequent imaging demonstrated avascular necrosis of the lunate bone. Interventions included autologous cytokine-rich serum injections, pharmacological pain management, and ultimately surgical lunate excision with bone grafting due to progression of the disease. This case represents the first reported instance of Kienböck's disease developing after COVID-19 infection. Increased clinician awareness may lead to earlier diagnosis and better functional outcomes.