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Bilateral Kienbock's disease in SLE

C C Mok1, C S Lau, P W Cheng

  • 1Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong.

Scandinavian Journal of Rheumatology
|January 1, 1997
PubMed
Summary
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Kienbock's disease, or avascular necrosis of the lunate, is rare in young adults. This case report details bilateral Kienbock's disease in a patient with systemic lupus erythematosus, potentially linked to vasculopathy.

Area of Science:

  • Orthopedics
  • Rheumatology
  • Vascular Medicine

Background:

  • Kienbock's disease is avascular necrosis (AVN) of the carpal lunate, an uncommon condition primarily affecting young adults.
  • Etiology is multifactorial, involving mechanical, anatomical, and vascular factors, but remains uncertain.
  • Systemic lupus erythematosus (SLE) is an autoimmune disease with potential vascular complications.

Observation:

  • A patient with systemic lupus erythematosus (SLE) presented with bilateral Kienbock's disease.
  • The onset of Kienbock's disease occurred during the course of the patient's SLE illness.
  • Bilateral carpal lunate avascular necrosis was diagnosed radiologically.

Findings:

  • The development of bilateral Kienbock's disease in an SLE patient suggests a potential link.

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  • Vasculopathy, possibly due to active vasculitis or antiphospholipid antibodies associated with SLE, is implicated.
  • This association highlights a possible, though uncommon, manifestation of SLE-related vascular compromise.

    • Implications:

    • This case suggests that SLE-related vasculopathy may contribute to the development of Kienbock's disease.
    • Further research is warranted to explore the relationship between autoimmune diseases, vasculopathy, and carpal bone necrosis.
    • Understanding this link could inform diagnostic and therapeutic strategies for patients with SLE and carpal abnormalities.