108 Part I Chapter 4 Figure 6 Forty-seven-year-old paver with pain in the wrist. Conventional X-ray (A) shows complete collapse and fragmentation of lunate (arrow) consistent with Kienböck’s disease stage IIIb. Planar late-phase image (B) shows increased uptake in the carpal bones (arrow), and CT (C) and fused SPECT/CT (D) confirm destruction of the lunate (arrow) and increased activity in the surrounding carpals (arrow) and distal radius.