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J Wrist Surg
DOI: 10.1055/a-2772-0920
Case Report

Lunate Osteoid Osteoma Mimicking a Subchondral Cyst and Kienböck's Disease

Authors

  • Michał Bonczar 

    1   Intermed Medical Center, Kraków, Poland
    2   Youthoria, Youth Research Organization, Kraków, Poland
    3   Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland

  • Patryk Ostrowski

    1   Intermed Medical Center, Kraków, Poland
    2   Youthoria, Youth Research Organization, Kraków, Poland
    3   Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland

  • Martyna Dziedzic

    1   Intermed Medical Center, Kraków, Poland
    2   Youthoria, Youth Research Organization, Kraków, Poland
    3   Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland

  • Mariusz Bonczar

    1   Intermed Medical Center, Kraków, Poland
    2   Youthoria, Youth Research Organization, Kraków, Poland

Funding Information The authors received no financial support for the research, authorship, and/or publication of this article.
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Abstract

Introduction

Osteoid osteoma is a benign bone tumor most commonly affecting long bones, with only 5–15% occurring in the bones of the hand and approximately 0.075–0.225% in the lunate. Due to its rarity, the clinical presentation of lunate osteoid osteoma is poorly characterized, and differential diagnosis remains challenging.

Case Report

We report the case of a 31-year-old female presenting with a 12-year history of chronic wrist pain. Over this period, two surgeries targeting suspected Kienböck's disease were performed, based on clinical and radiological findings, including a distal radius osteotomy and a capitate shortening osteotomy - both without symptom relief. Upon admission to the author's clinic, a thorough reassessment of the patient's clinical course and imaging studies prompted reconsideration of the initial diagnosis. Despite negative findings on both CT and the aspirin test - modalities commonly utilized in the diagnostic workup of osteoid osteoma - surgical intervention was undertaken, targeting the cystic lesion. Intraoperatively, a small, well-demarcated fragment consistent with osteoid osteoma was identified and excised. Histopathological analysis confirmed the diagnosis, and the patient experienced immediate and sustained resolution of symptoms following the procedure.

Conclusion

This case exemplifies the substantial diagnostic difficulty posed by osteoid osteomas in uncommon locations, particularly when radiological and clinical findings mimic more prevalent conditions such as Kienböck's disease. Expanding the body of literature concerning both typical and atypical presentations of osteoid osteomas within the lunate is critically needed to facilitate earlier and more effective management of patients affected by this condition.

Keywords

osteoid osteoma - Kienböck - Kienböck's disease - subchondral cyst - lunate

Data Availability Statement

The data presented in this study are available on request from the corresponding author.


Ethical Approval

Not applicable.


Informed Consent

The patient has provided written informed consent for the publication of this article, including all relevant clinical data and images.




Publication History

Received: 18 August 2025

Accepted: 12 December 2025

Article published online:
29 December 2025

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