Multidetector CT arthrography of the wrist joint: how to do it

With its exquisite spatial resolution, multidetector computed tomographic (CT) arthrography of the wrist is a valuable tool for the diagnosis and evaluation of a wide spectrum of articular disorders. Traumatic tears of the interosseous ligaments can be classified as complete or incomplete and as partial- or full-thickness tears at multidetector CT arthrography and can also be differentiated from asymptomatic degenerative lesions. In addition, tears of the triangular fibrocartilage complex can be differentiated according to their location. A tailored contrast material injection technique and multiplanar reformation are recommended for optimal assessment of these structures. Multidetector CT arthrography is also remarkably effective in demonstrating cartilage and bone abnormalities, many of which cannot be depicted with other imaging techniques. The chief limitation of multidetector CT arthrography lies in the evaluation of soft-tissue abnormalities, which may benefit from the addition of other imaging techniques such as ultrasonography or magnetic resonance imaging. A basic knowledge of the relevant anatomy, pathophysiologic features, and imaging technique is mandatory for obtaining high-yield diagnostic information concerning the wrist joint. (c) RSNA, 2008.