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Stiffness in hand. MRI shows Keanboch disease. Blood test shows high ESR rate. What to do?

hello doctor... my mom having stiffness in her hand and also she can t streatch her fingers completely(in both hands) the mri scan report shows that she has keanboch desease. she need to under go a surgery to remove lunar bone in her hand. we consult another ortho doctor, he told us it is curable by some excersises, so need not have any surgery. then some physiotherophy excersise were given. but her condition remains same. now her blood test shows that, she has high esr rate (61mm/hr). also total LEUCOCYTE ( WBC ) is 0000. i am afraid about this. what will we have to do next? is it a serious problem? what will be the treatment process?
Asked On : Wed, 19 Dec 2012
Answers:  1 Views:  51
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Orthopaedic Surgeon 's  Response

Thanks for writing in.

Kienbock's disease with high ESR and total leucocyte count might indicate some kind of inflammatory process going on there. It can be due to Rheumatoid arthritis also.

1. Is there any other joint involvement - particularly small joints of hand with/without swelling?
2. Is there low grade fever in evening? loss of appetite or weight?

Discuss with your doctor. He might order few additional blood tests - CRP, ASO titre, RA factor, S.Uric acid.

Rheumatoid arthritis / Inflammatory arthropathy respond well to oral medications. But if the Kienbock's disease is severe, then she needs surgical removal of the lunate bone.

Hope i have answered your query. Feel free to ask any doubts.

Wish your mom a good health.
Answered: Thu, 20 Dec 2012
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