Wrist injuries: pitfalls in conventional imaging

The general principles of judging wrist injuries are discussed. Carefully made standard views will provide recognizable projections of carpal bones in order to judge abnormal positions. Additional views, conventional tomography and CT scans are, in some instances, necessary to diagnose fractures. For ligamentous damage resulting in carpal instability, fluoroscopy of the wrist and/or an arthrogram should be obtained. Examples of difficult pathology are shown and variations or more or less borderline pathology as coincidental findings are discussed. The main pitfalls are: wrong diagnosis made on inappropriately taken radiographs; misinterpretation of carpal bone relationships; and overestimation of some arthrographically found abnormalities.