Lunate osteomyelitis in a patient with bilateral Kienböck's disease.

Kienböck's disease, which is osteonecrosis of the carpal lunate bone, was described by Peste in 1843 and by Kienböck in 1910. Histologic studies of affected lunate bones have revealed avascularity, osseous necrosis, fragmentation, and fibrous proliferation. The disease most often occurs between the ages of 20 to 40 years, and the onset is usually insidious. There may be a history of a single episode or repetitive trauma, although this is not the rule. The patient usually will present with pain and decreased motion of the wrist. X-ray will reveal sclerosis of the lunate of varying degrees. There are many theories of how the inciting event of avascular necrosis takes place. There are several reports in the American literature of unilateral disease complicated by osteomyelitis, but to our knowledge there are no reports of bilateral Kienböck's with one side complicated by osteomyelitis.