Three cases of osteonecrosis of the lunate bone of the wrist in scleroderma.

This report describes three cases of osteonecrosis of the lunate bone of the wrist in patients with systemic sclerosis presenting with wrist pain. All three patients had limited skin scleroderma but severe Raynaud's phenomenon. Two patients never received corticosteroids and one patient received only low doses for a brief period. None of the patients had other definable risk factors for osteonecrosis. Two patients underwent vascular bone grafting with improvement in symptoms. Osteonecrosis may represent an under-recognized cause of wrist pain in scleroderma patients.