This relatively unusual condition is of unknown cause. It occurs most commonly in the dominant hand of men aged 20 to 45 yr. Symptoms and Diagnosis Symptoms generally start with insidious onset of wrist pain, localized to the region of the lunate carpal bone, and patients have no recollection of trauma. Diagnosis may be accomplished at an early stage by MRI or CT and confirmed by the x-ray appearance of a sclerotic lunate, which gradually develops cystic changes and a coronal fracture and collapses. Treatment Treatment is aimed at relieving pressure on the lunate by surgery to shorten the radius or lengthen the ulna.
Alternative treatments attempt to revascularize the lunate.
Salvage procedures are required once the lunate has collapsed and produced fixed rotation of the scaphoid and subsequent degeneration of the carpal joints. Total wrist arthrodesis is performed as a last resort to relieve pain when the condition has progressed to an advanced stage. Cystic swellings occurring on the hands, especially on the dorsal aspect of the wrists. Another type of cystic ganglion on the dorsal wrist occurs in patients with RA, but it is easily recognized by its soft irregular appearance in association with other evidence of rheumatoid extensor synovitis. The cause is obscure.