The Schmitt classification is commonly used MRI-based classification system for assessing Kienböck disease and is used to guide management and assess prognosis.
Classification
stage N: normal lunate signal and no gadolinium enhancement
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stage A (ischemia):
proximal lunate has high T2 signal (edema) and low T1 signal, and with gadolinium enhancement
the distal lunate maintains normal signal
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stage B (partially necrotic):
proximal lunate has high or low T2 signal and low T1 signal, but no gadolinium enhancement and an adjacent enhancing reparative zone
the distal lunate maintains normal signal
stage C (completely necrotic): proximal lunate has high or low T2 signal and low T1 signal, but no gadolinium enhancement in the entire lunate
See also
Lichtman classification (x-rays)
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