MR imaging of the painful wrist

Magnetic resonance (MR) imaging is an effective method for helping determine the cause of wrist pain by demonstrating a broad spectrum of abnormalities, including those of bone, cartilage, ligaments, and tendons. MR imaging is useful in the detection, characterization, and staging of osseous injury and disease, although computed tomography provides superior detail in the depiction of bone. MR imaging may demonstrate irregular cartilage loss in noninflammatory arthropathies such as osteoarthritis, and its superior soft-tissue contrast makes it the method of choice for evaluating the synovial processes. Although arthrography remains the standard of reference in the detection of perforations of the principal intrinsic ligaments of the wrist, three-dimensional MR imaging has shown promise in depicting the small interosseous ligaments. Tendinitis, tenosynovitis, ganglia, and anatomic variants can be diagnosed and accurately assessed with MR imaging. Radiologists need to be aware of the full spectrum of wrist abnormalities and the characteristic MR imaging findings that accompany them.