Figure 1: Case 1 (a– d): MRI coronal T1-weighted image, coronal T2-weighted image, and short TI inversion recovery (STIR), respectively, show evidence of avascular necrosis of the lunate bone. (a) Altered marrow signal with hypointense signal in T1-weighted image (white arrow) associated with chondromalacia at the opposing surfaces of the capitates and hamate bones (blue arrows). (b, c) intermediate signal intensity is seen in the lunate bone in coronal T2-weighted image with residual normal marrow signal associated with subarticular cystic changes seen at the second carpometacarpal articulation involving the opposing articular surfaces (white arrows). (c) Synovitis is seen at the radiocarpal articulation with effusion and bulging synovial recess showing mild synovial thickening. (d) STIR-weighted image showing mixed signal intensity of the lunate bone and cystic nature of the subarticular second carpometacarpal joint lesion (white arrow).