The Etiology of Keenbox Disease

A 30 year old right hand dominant accountant has progressive wrist pain for the last 18 months. He was initially treated in a cast, but his symptoms have continuously worsened. An a p of the wrist shows the lunate is collapsed and there is a loss of corpal height secondary to proximal capitate migration. A lateral x ray demonstrates a flex scaphoid; he reports decreased grip strength. And physical exam is significant for decreased wrist extension and tenderness over the radio corporal joint. All the other choices are wrist factors for development of keen box disease, except for increased carpal height. Conversely, a decrease in the carpal height is associated with a vascular neucrosis of the lun