THE SPONTANEOUS COURSE OF LUNATE NECROSIS

Reconstruction of the natural course of lunate necrosis is difficult b ecause of incomplete findings, especially in the initial stages. The n ecrosis progresses steadily from initial lunate oedema with a normal X -ray appearance to condensation, fragmentation and collapse of the lun ate within months. The collapse of the whole carpus means a dramatic d eterioration in therapeutic possibilities not much later. In order to start treatment successfully in the initial stage, suspicious findings should be repeatedly followed up by X-ray films and magnetic resonanc e imaging. The development of degenerative changes often takes years. The clinical findings are not helpful in judging the course of the dis ease as pain varies and only the collapse of the lunate and late arthr osis accentuate pain.