Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive right wrist pain localized to the dorsal aspect, exacerbated by gripping and weight-bearing activities. Reports associated stiffness, decreased range of motion, and intermittent swelling. No history of acute trauma. Symptoms consistent with Kienbockโs disease (M87.131).
Clinical Examination Findings
Right wrist examination reveals localized tenderness over the lunate fossa. Range of motion is restricted in flexion/extension. Grip strength is diminished compared to the contralateral side. No signs of acute infection or neurovascular compromise. Radiographic findings demonstrate lunate sclerosis and/or collapse consistent with Kienbock's disease.
Treatment Protocol
Management plan includes activity modification, immobilization with a wrist splint, and non-steroidal anti-inflammatory drugs (NSAIDs). Referral for advanced imaging (MRI) to assess stage. Surgical consultation for potential revascularization, proximal row carpectomy, or fusion depending on Lichtman stage.