[A prospective study of early diagnosis of lunate necrosis by means of MRI].

AIM: Early recognition of lunate necrosis by means of MRI.

METHODS

49 patients with typical symptoms and normal radiographs were examined. Coronary T1 and T2 weighted images were obtained. In addition, an attempt was made to quantify fluid shift and measure of bone marrow oedema by means of extreme T2 weighting (TR 5950 ms, TE 150 ms).

RESULTS

Three instances of necrosis were found; in two cases it was possible to demonstrate marrow oedema. Oedema preceding necrosis could not be demonstrated by quantifying a grey scale.

CONCLUSIONS

The pattern of pain in the region of the lunate is not typical and is usually not of bone origin. Early MRT will show lunate necrosis only rarely; nevertheless, the therapeutic consequences justify the examination if pain persists for several weeks. Extreme T2 weighting for quantifying a grey scale to demonstrate early marrow oedema has not proved useful. Our experience suggests that T2 weighting is adequate and is the method of choice for the early recognition of necrosis of the lunate.