MRI findings and clinical results after radial osteotomy for Kienboeck's disease

We evaluated the correlation between MRI findings and clinical results after radial osteotomy for Kienboeck's disease. Sixteen patients (13 men and 3 women) treated by either radial osteotomy or radial wedge osteotomy were included in the study. The mean age at the time of the surgery was 29.9 years. A postoperative MRI was obtained at an average of 33 months after the operation. According to Nakamura's scoring system (N score), the final clinical results were divided into two groups: 11 wrists in the excellent/good (E/G) group and 5 wrists in the fair/poor (F/P) group. We evaluated signal intensity of the lunate in three groups: low (L), slight low (SL) and iso (I) compared with the other carpal bones. The high-intensity area in the lunate on the T2-weighted image (T2WI) was defined as the ''hot spot area''. Changes in signal intensity on both the T1WI and T2WI varied in each patients. In the E/G group, the majority of cases showed signal intensity improvement on either the T1WI or T2WI. In contrast, improvement was not observed in the majority of patients in the F/P group. The ''hot spot area'' more often appeared in the E/G group than in the F/P group. In conclusion, the improvement of the signal intensity was more frequently observed in the E/G group than in the F/P group, but clinical outcomes were poorly predicted from the preoperative MRI findings. (author)