Presentation
Ulnar side wrist pain and swelling not responding to splint and medications
Patient Data
Abnormally decreased T1 and increased T2 signal of the dorsal aspect of lunate bone as well as opposing tip of hamate with associated subchondral cystic changes likely related to chondromalacia and bone marrow edema. "Type II" lunate configuration, with an extra facet between the lunate and the hamate. Narrowed lunate-capitate joint space with associated intercarpal joints effusion and patchy bone marrow edema of the distal capitate.
Red circles highlight chondromalacia of the tip of hamate and lunate bones
Green circle highlights intercarpal joints osteoarthritis.
Case Discussion
Hamatolunate impingement occurs when there is type II lunate morphology (presence of a medial facet on the distal lunate for articulation with the hamate). This alters wrist mechanics with repeated impaction of the opposing articular surfaces results in chondromalacia and degenerative joint disease.
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