Kienbock disease

Discussion:

X-rays demonstrate sclerosis and irregularity of the lunate

MRI confirms absence of normal bone marrow signal (best seen on T1 sequence) with a thin rim of high T2 signal at the periphery of the ossified center (best seen on STIR).

Note also the apparent negative ulnar variance

Although the demographics are atypical, the finidings are thought most likely to represent AVN of the lunate (Kienbock disease). 

Case courtesy of Dr Yume Kohno. 

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