Diagnostic Imaging for Osteonecrosis of the Lunate

Initial Diagnostic Confirmation

Plain radiographs, including anteroposterior, lateral, and oblique views, should be used to exclude fracture, arthritis, or tumor, though radiographs are less sensitive for early disease, as recommended by the American College of Radiology 1, 2
MRI without contrast is the gold standard for diagnosis when radiographs are normal or nonspecific, as it can detect early osteonecrosis before radiographic changes appear, according to the American College of Radiology 3, 4
CT may be appropriate for surgical planning when the degree of collapse or bone fragment size is uncertain from radiographs, as suggested by the American College of Radiology 4

Protected weight-bearing and regular radiographic follow-up are essential after any surgical intervention to monitor for progression, as recommended by Praxis Medical Insights 5