A PROSPECTIVE-STUDY FOR THE EARLY RECOGNI TION 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 T-1 and T-2 weighted images were obtained. In addition, an at tempt was made to quantify fluid shift and measure of bone marrow oede ma by means of extreme T-2 weighting (T-R 5950 ms, T-E 150 ms). Result s: Three instances of necrosis were found; in two cases it was possibl e 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; neverth eless, the therapeutic consequences justify the examination if pain pe rsists for several weeks. Extreme T-2 weighting for quantifying a grey scale to demonstrate early marrow oedema has not proved useful. Our e xperience suggests that T-2 weighting is adequate and is the method of choice for the early recognition of necrosis of the lunate.