Diagnosis and clinical findings of Kienböck's disease.

The clinical presentation and history of patients with Kienböck's disease do not permit differentiating avascular necrosis of the lunate from vague wrist pathology of a variety of causes. Diagnosis and evaluation of this disorder therefore require appropriate imaging studies. Plain-film radiography, tomography, and bone scintigraphy are useful screening tests, but MRI yields a definitive diagnosis. CT is also valuable for delineating structural changes and the amount of collapse in the lunate. The staging of Kienböck's disease is based on clinical and radiographic data.