{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T05:19:28Z","timestamp":1763097568572,"version":"3.45.0"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>This exploratory study investigates the feasibility and diagnostic value of high-resolution peripheral quantitative computed tomography (HR-pQCT) in detecting structural and microarchitectural changes in lunate avascular necrosis (AVN), or Kienb\u00f6ck\u2019s disease. Five adult patients with unilateral AVN underwent either MRI or CT, alongside HR-pQCT of both wrists. Imaging features such as subchondral remodeling, joint space narrowing, and bone fragmentation were assessed across modalities. HR-pQCT detected at least one additional pathological feature not seen on MRI or CT in four of five patients and revealed early subchondral changes in two contralateral asymptomatic wrists. Quantitative measurements of bone volume fraction (BV\/TV) further indicated altered trabecular structure correlating with disease stage. These findings suggest that HR-pQCT may offer enhanced sensitivity for early-stage AVN and better delineation of disease extent, which is critical for informed surgical planning. While limited by small sample size, this study provides preliminary evidence supporting HR-pQCT as a complementary imaging tool in the assessment of lunate AVN, with potential to improve early detection, staging accuracy, and individualized treatment strategies.<\/jats:p>","DOI":"10.3390\/jimaging11110406","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T06:55:04Z","timestamp":1762930504000},"page":"406","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) for Assessment of Avascular Necrosis of the Lunate"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2193-7746","authenticated-orcid":false,"given":"Esin","family":"Rothenfluh","sequence":"first","affiliation":[{"name":"Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg F.","family":"Erbach","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Medical Faculty, University of Bern, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e9na G.","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6010-7886","authenticated-orcid":false,"given":"Laura","family":"De Pellegrin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela A.","family":"Frauchiger","sequence":"additional","affiliation":[{"name":"ARTORG Center for Biomedical Engineering Research, University of Bern, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4440-2338","authenticated-orcid":false,"given":"Rainer J.","family":"Egli","sequence":"additional","affiliation":[{"name":"Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/1753193410373862","article-title":"Reliability and reproducibility of Kienbock\u2019s disease staging","volume":"35","author":"Goeminne","year":"2010","journal-title":"J. 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