Type II lunate with hamatolunate impingement

Case contributed by Matt A. Morgan


Ulnar-sided wrist pain

Patient Data

Age: 45-50 years
Gender: Male

Type II lunate


There is a small facet between the lunate and the tip of the hamate, with abnormally decreased T1 and increased T2 signal due to bone marrow edema in the proximal hamate.

Case Discussion

Approximately half of all wrists have the "type II" lunate configuration, with an extra facet between the lunate and the hamate.

This configuration may lead to altered wrist mechanics, accelerated cartilage loss at the facet, and the eventual development of impingement and pain.  A type II lunate is in the differential of ulnar-sided wrist pain and MRI can nicely show bone marrow edema from impingement.

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