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Lunate Chondromalacia: Evaluation of Routine MRI Sequences

¹ Department of Radiology, Hospital for Joint Diseases Orthopaedic Institute, Bernard Aronson Plaza, 301 E 17th St., 6th Fl., New York, NY 10003.
² Present Address: Radiology Department, Hospital das Clinicas, University of Sao Paulo School of Medicine, Av. Eneas de Carvalho de Aguiar, 255, 05403-001, São Paulo, Brazil.
³ Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA.
⁴ Department of Orthopedic Surgery, Philadelphia Hand Center, King of Prussia, PA.

OBJECTIVE. Chondromalacia is a commonly encountered abnormality at arthroscopy and may be responsible for significant clinical symptoms and disability. In the wrist, the most common location for chondromalacia is the lunate bone. Consequently, we sought to study the accuracy of clinical MRI in the assessment of lunate articular cartilage.

MATERIALS AND METHODS. MR images of 34 patients who underwent arthroscopy and had an MRI examination within 1 month of surgery were evaluated by two reviewers for the presence and location of lunate cartilage defects and subchondral edema.

RESULTS. Lunate cartilage defects were seen on MRI in 10 of the 13 patients with chondromalacia, but these defects were also incorrectly noted in three of 21 of patients without chondromalacia. The visible locations for cartilage defects were the ulnar aspect of the proximal lunate bone (n = 3), radial aspect of the proximal lunate bone (n = 4), ulnar aspect of the distal lunate bone (n = 2), and radial aspect of the distal lunate bone (n = 1). Subchondral marrow edema was observed in six of the 10 patients with chondromalacia seen on MRI; in all six patients, the edema was seen in the same quadrant as the cartilage defect. Marrow edema was detected in one patient without chondromalacia.

CONCLUSION. We conclude that lunate chondromalacia can be accurately assessed using routine MRI sequences, although there are occasional false-positive interpretations.

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