Digital subtraction in multi-compartment arthrography of the wrist

In a series of 23 patients with chronic and unexplained painful wrist, three-compartment arthrography was carried out using digital subtraction. Pathologic conditions were disclosed in 19 patients. Digital subtraction both allowed for a stronger diluting of the dye and for the demonstration of a larger amount of lesions of smaller size than conventional wrist-arthrography, as long as motion artefacts had been avoided. Obtaining successive views without having to wait for complete contrast resorption in the injected compartments represents a significant advantage. The importance of three-compartment injection is stressed and the best way to perform the technique is discussed. As it proved to be a fast and reliable examination procedure the authors advocate using digital subtraction arthrography of the wrist whenever the method is available. However, this relatively new technique does not rule out careful correlation between arthrographic findings and clinical complaints.