Causes of abnormal lunate signal on MRI

Last revised by Amanda Er on 15 Sep 2022

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%).1 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

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Cases and figures

  • Ulnar impaction syndrome
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  • Ulnar impaction syndrome
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