Kienbock's Disease is diagnosed radiographically. The characteristic changes of the lunate include increased density, fracture lines, fragmentation, and progressive collapse of the lunate.

It should be distinguished from other causes of wrist pain and swelling particularly in the early stages.

Disorders to rule out include rheumatoid arthritis, post traumatic arthritis, synoval based disease, acute fracture, carpul instability, and ulnar abutment syndromes. The radiographic hallmark of increased density seen typically in Kienbock's disease should be distinguished from transient vascular compromise.

Once the Diagnosis of Kienbock's Disease is established, the degree of involvement should be determined in order to assist you through the many treatment options. Casting for 2 to 3 weeks in uncertain cases will usually reveal the diagnosis by relative disuse osteoporosis of the adjacent carpul bones.

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