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Semin Musculoskelet Radiol 2025; 29(06): 863-870
DOI: 10.1055/s-0045-1810630
Review Article

The Signal-Compromised Lunate

Authors

  • Jan-Peter Grunz 

    1   Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany

  • Karsten Sebastian Luetkens 

    1   Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany

  • Rainer Schmitt 

    1   Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
    2   Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
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Abstract

A wide spectrum of conditions can trigger signal alterations in the lunate bone. From vascular complications such as Kienböck's disease to axial microtrauma in ulnocarpal impaction syndrome, the lunate signal is an essential indicator of carpal health. Many of the pathologies described in this review rely on magnetic resonance imaging for analysis; however combined assessment of patient history, clinical symptoms, and imaging is often the only way to find the correct diagnosis. Standard radiography serves as the first-line modality for diagnostic assessment in most patients, but morphological analyses are more precise when based on high-resolution computed tomography imaging. Because gadolinium enhancement (not edema) is the deciding factor in the vitality assessment of the lunate, the imaging work-up of suspected osteonecrosis should include intravenous administration of contrast agent to discern viable tissue and so-called repair zones from entirely necrotic bone.

Keywords

lunate - osteonecrosis - Kienböck's disease - impaction syndrome - carpus

Declaration of Generative AI and AI-assisted Technologies in the Writing Process

During the preparation of this work, we used ChatGPT 4o to improve readability of the article. After using this tool, we reviewed and edited the content as needed, and we take full responsibility for the content of the article.


Financial Disclosure

Jan-Peter Grunz receives grants from Siemens Healthineers and also payment from the company.




Publication History

Article published online:
03 December 2025

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