Hamatolunate impingement

Case contributed by Dr Tim Luijkx

Presentation

Contusion hand/wrist two years ago. Now pain and swelling dorsal aspect of the hand.

Patient Data

Age: 55 years
Gender: Male
X-ray

Lunate type 2 morphology with lucent areas in adjacent areas of lunate and hamate.

MRI

Location of pain marked (dorsal of the base of MC2 and MC3).

There is a type 2 lunate morphology with the articulation of hamate and lunate. Bone marrow edema is located in the proximal aspect of the hamate and cystic lesion in the lunate. Cartilage defect between lunate and hamate, best appreciable on coronal PD. 

Case Discussion

Findings are consistent with hamatolunate impingement syndrome resulting in cartilage damage and bone marrow edema. These findings may very well explain the patient's pain located slightly distally from the hamate-lunate articulation.

The anatomy of the lunate bone can be determined on plain films. When there is an articulation with the hamate there is a lunate type 2 configuration, which predisposes for hamatolunate impingement.

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