Three cases of osteonecrosis of the lunate bone of the wrist in scleroderma

This report describes three cases of osteonecrosis of the lunate bone of th e wrist in patients with systemic sclerosis presenting with wrist pain. All three patients had limited skin scleroderma bur severe Raynaud's phenomeno n. Two patients never received corticosteroids and one patient received onl y, low doses for a brief period. None of the patients had other definable r isk factors for. osteonecrosis. Two patients underwent vascular bone grafti ng with improvement in symptoms. Osteonecrosis may represent an underrecogn ized cause of wrist pain in scleroderma patients.