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MR Imaging of Ulnocarpal Impaction After Fracture of the Distal Radius

¹ Department of Clinical Radiology, Ludwig Maximilians University, Klinikum Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany.
² Department of Surgery, Ludwig Maximilians University, Klinikum Grosshadern, D-81377 Munich, Germany.
³ Department of Orthopedic Surgery, Ludwig Maximilians University, Klinikum Grosshadern, D-81377 Munich, Germany.

View larger version (149K): [in a new window]   Fig. 1A. —44-year-old man with distal radius fracture and posttraumatic edema of lunate. Coronal STIR image obtained 8 weeks after trauma shows focal bone marrow edema of proximal ulnar- and radial-sided lunate (arrows). Metal artifacts are caused by internal plate fixation of distal radius.

View larger version (162K): [in a new window]   Fig. 1B. —44-year-old man with distal radius fracture and posttraumatic edema of lunate. Coronal STIR image obtained 8 weeks after A shows that focal bone marrow edema of lunate is no longer detectable. Minor diffuse increase of bone marrow signal is most likely related to reactive changes in bone metabolism.

View larger version (172K): [in a new window]   Fig. 2A. —54-year-old man with early development of ulnocarpal impaction. Coronal STIR image obtained 8 weeks after distal radius fracture shows focal bone marrow edema at proximal ulnar-sided pole of lunate (arrow).

View larger version (166K): [in a new window]   Fig. 2B. —54-year-old man with early development of ulnocarpal impaction. Coronal STIR image obtained 8 weeks after A shows that focal bone marrow edema at proximal ulnar-sided pole of lunate is still clearly detectable (solid arrow). Note complete rupture of radial attachment of triangular fibrocartilage (open arrow).

View larger version (129K): [in a new window]   Fig. 3A. —61-year-old woman with distal radius fracture and increasing ulnocarpal impaction. STIR image obtained 8 weeks after trauma shows linear subchondral bone marrow edema along proximal surface of lunate (solid arrow) and along distalmost ulnar head (open arrow). Note suspicion of triangular fibrocartilage rupture.

View larger version (113K): [in a new window]   Fig. 3B. —61-year-old woman with distal radius fracture and increasing ulnocarpal impaction. On STIR image obtained 16 weeks after A, bone marrow edema of lunate has distinctively increased (solid arrow). Torn triangular fibrocartilage can be seen with fluid extending into distal radioulnar joint (open arrow).

View larger version (119K): [in a new window]   Fig. 3C. —61-year-old woman with distal radius fracture and increasing ulnocarpal impaction. Posteroanterior radiograph obtained 16 weeks after trauma shows complete fracture healing with posttraumatic shortening of distal radius. As result of ulnocarpal impaction, subchondral demineralization can be seen in proximal portion of lunate (arrow).

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