lunate signal change on MRI

There are several important causes of an abnormal lunate signal on MRI, the most frequent causes being Kienbock disease (25%), ulnar impaction syndrome (25%) and intraosseous ganglia (20%).Appreciation of the pattern of bone signal change can often allow the correct diagnosis to be made.

  • Kienbock disease
    • sclerosis (low T1 and T2) centrally and within the radial aspect of lunate
    • sclerosis can be diffuse
    • bone edema (high T2, intermediate T1) may be seen in the acute phase, particularly on the radial side
    • 75% of cases are associated with negative ulnar variance
  • ulnar impaction syndrome 
    • sclerosis (low T1 and T2) localized to the proximal ulnar aspect of lunate
    • bone edema (high T2, intermediate T1)
    • chondromalacia of distal ulnar and proximal lunate cartilage
    • commonly associated with positive ulnar variance
  • intraosseous ganglia
    • round T2 hyperintense regions 
    • usually radial side of the lunate or distal lunate
  • lunate fracture
    • diffuse bone edema (high T2, intermediate T1)
    • linear fracture line (low T1 and T2)
  • others
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