Cyst-like lesions of the lunate resembling Kienbock's disease: A case report

A 33-year-old man presented with a cyst-like lesion of the lunate resemblin g Kienbock's disease. Radiographs showed collapse of the proximal portion o f the lunate and a lucent lesion in the triquetrum. T1-weighted magnetic re sonance images showed a low signal in the collapsed part of the lunate but not in the remaining area. During surgery the lesion of the triquetrum cont ained serous fluid and the lunate was partially collapsed. Histologically, the triquetrum consisted of fibrous connective tissue and the lunate consis ted of a mixture of bone, cartilage, and fibrous tissue without necrosis. T he lunate lesion was diagnosed as a collapsed cyst-like lesion, although ra diographs resembled Kienbock's disease. The lesion was successfully treated surgically with curettage, bone grafting, and external skeletal fixation. The patient is asymptomatic 3.5 years after surgery with some recovery of t he trabecular pattern of the lunate. (J Hand Surg 2001;26A:130-134. Copyrig ht (C) 2001 by the American Society for Surgery of the Hand.).