Imaging of the wrist

A wide variety of radiologic tools now exists for the assessment of the bones and soft tissues of the wrist. The selection of the most appropriate modality requires that the radiologist be conversant both with this armamentarium and with the needs of the referring clinician requesting diagnostic help. Although most static abnormalities may be nicely displayed on routine plain films and special projections, many dynamic abnormalities require motion or stress views to demonstrate their presence. The three-phase radionuclide bone scan allows the radiologist to judge the acute or chronic nature of the abnormality being assessed. Subluxations involving the distal radioulnar joint are relatively easily recognized with CT scanning through that joint. These abnormalities are seen infrequently and are unreliably diagnosed from the plain film examination alone. Although the triple injection arthrogram seems to be a sensitive and accurate tool for identifying ligamentous perforations including those of the triangular fibrocartilage, the potential for those diagnoses to be made with MR imaging is increasingly recognized.