Lichtman's radiographic classification of aseptic necrosis of lunate bone Kienbock's disease

Kienbock's disease is an eponym for avascular necrosis of the lunate bone. It usually affects man working manually with tools like pneumatic hammer that cause repetitive trauma.

Stage Description
Stage I normal x-ray
Stage II sclerosis of lunate with possible decrease of lunate height on radial side only
Stage IIIa lunate collapse, no scaphoid rotation
Stage IIIb lunate collapse, fixed scaphoid rotation
Stage IV degenerative changes around the lunate


1. Goldfarb CA, Hsu J, Gelberman RH, Boyer MI. The Lichtman classification for Kienböck’s disease: an assessment of reliability. J Hand Surg Am. 2003 Jan;28(1):74–80.
2. Saunders BM, Lichtman D. A classification-based treatment algorithm for Kienböck disease: current and future considerations. Tech Hand Up Extrem Surg. 2011 Mar;15(1):38–40.