title: Kienböck's disease associated with radiocephalic fistula formation in a patient with end-stage renal disease.
abstract: Kienböck's disease, which consists of osteonecrosis and collapse of the lunate bone, causes chronic pain and dysfunction of the wrist. Patients on hemodialysis are occasionally present with wrist pain, but Kienböck's disease is rarely reported in dialysis patients. This case study describes Kienböck's disease in a patient with end-stage renal disease on hemodialysis. A 39-year-old male with a 1-year history of hemodialysis presented with left wrist pain that increased progressively over 6 months. The patient had no history of trauma or any other risk factors known to be associated with Kienböck's disease. Physical examination of the wrist at the site of the arteriovenous fistula showed swelling and tenderness with decreased range of motion. Radiographic examination showed articular collapse and fracture of the body of lunate consistent with stage IIIb Kienböck's disease. An intercarpal arthrodesis with autogenous bone graft was performed.
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Gun Woo
authors.initials: GW
authors.lastname: Kang
authors.forename: Da Young
authors.initials: DY
authors.lastname: Lee
authors.forename: Young-Hwan
authors.initials: YH
authors.lastname: Lee
authors.forename: Ki Sung
authors.initials: KS
authors.lastname: Ahn
authors.forename: Shin-Kun
authors.initials: SK
authors.lastname: Kim
authors.forename: In Hee
authors.initials: IH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology; D008297:Male; D010020:Osteonecrosis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D017534:Radial Artery / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: Kienböck's disease; arteriovenous fistula; end-stage renal disease; hemodialysis