[Sonography of the wrist and the hand]

Sonographic examination of the hand requires high-frequency linear transducers. As the relevant structures are located very close to the surface, water stand-off pads are mandatory. Owing to the high sensitivity of sonography in the detection of fluid, exudative synovitis, tenosynovitis and ganglia can be easily diagnosed. Sonographic information on muscle atrophy and alterations of the shape and echogenicity of the median nerve in patients with carpal tunnel syndrome may be useful in evaluating the extent of disease. Further indications for the sonographic examination of the hand include suspected tumors, foreign bodies and synovial proliferation. Osseous destruction can be visualized in patients with rheumatoid disease, but the precise extent is hard to determine.