D) Collapse/fragmentation with degenerative changes involving the carpals is correct.
 

Diagnosis

Kienböck disease.

Imaging Findings

AP plain film of the right wrist demonstrates sclerosis of the lunate with ulnar minus variance. Precontrast coronal T1 and post-contrast coronal T1 with fat saturation weighted images demonstrate abnormal marrow signal and enhancement within the lunate. Coronal STIR image demonstrates abnormal edema throughout the lunate. The findings are consistent with osteonecrosis. Final AP plain film demonstrates changes of radial osteotomy to compensate for ulna minus variance.