Lunate Chondromalacia: Evaluation of Routine MRI Sequences
Marcelo Bordalo-Rodrigues1,2,
Mark Schweitzer1,
Diane Bergin3,
Randall Culp4 and
Mohamed S. Barakat1
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.
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Fig. 1. —Drawing shows lunate was divided in four regions to determine
cartilage defects location: 1, distal ulnar aspect; 2, proximal ulnar aspect;
3, proximal radial aspect; and 4, distal radial aspect.
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Fig. 2A. —Indirect MR arthrogram in 40-year-old woman with arthroscopic
and MR evidence of lunate chondromalacia. Coronal fast spin-echo T2-weighted
MR image (TR/TE, 2,500/70) shows cartilage defect (arrowhead) and
adjacent bone marrow edema (white arrows). Scapholunate ligament
(black arrow) is thickened with abnormal high signal intensity within
it. Scapholunate ligament tear was confirmed at surgery.
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Fig. 2B. —Indirect MR arthrogram in 40-year-old woman with arthroscopic
and MR evidence of lunate chondromalacia. Coronal 3D gradient-echo MR image
(TR/TE, 45/12; flip angle, 10°) shows cartilage defect in lunate
(arrowhead).
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Fig. 2C. —Indirect MR arthrogram in 40-year-old woman with arthroscopic
and MR evidence of lunate chondromalacia. Arthroscopic image of proximal
radial aspect of lunate shows full-thickness chondral defect
(arrow).
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Fig. 3A. —Coronal MR images from false-positive examination in
50-year-old man. T1-weighted MR image (TR/TE, 400/9) shows ill-defined area of
low signal intensity in proximal radial aspect of lunate
(arrows).
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Fig. 3B. —Coronal MR images from false-positive examination in
50-year-old man. T2-weighted MR image (TR/TE, 2,500/70) shows ill-defined area
of high signal intensity in proximal radial aspect of lunate
(arrows), interpreted as edema secondary to chondromalacia. At
surgery, these signal abnormalities were noted to be cystic changes of lunate
bone, with no focal cartilage lesion associated.
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Fig. 4. —54-year-old woman with false-negative MRI study.
Three-dimensional coronal gradient-echo MR image (TR/TE, 45/10; flip angle,
10°) shows regular chondral surface of proximal lunate
(arrowheads). Minor arthritic changes of proximal radial aspect of
lunate were seen at arthroscopy. Surgically confirmed scapholunate ligament
tear (arrow) was noted.
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Fig. 5. —Schematic drawing of wrist joint shows that lunate acts as
intercalated segment, interposed between radius and capitate. Flexion and
extension motions are accomplished by radiolunate and lunocapitate joints.
Scaphoid and intercarpal ligaments prevents this unstable arrangement from
collapse when compression forces are applied. (Reprinted with permission from
[23]).
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Copyright © 2005 by the American Roentgen Ray Society.
