Search

The keys to successful ultrasonography (US) of the wrist include knowledge of the relevant anatomy and understanding the biomechanical aspects. A wide spectrum of pathological findings including bone fractures (scaphoid, triquetrum) and ligament lesions (dorsal intercarpal and radiocarpal ligaments, scapholunate ligament) can be caused by an identical traumatic mechanism determined on the basis of the position of wrist at the time of injury. In the setting of wrist trauma, an early diagnosis can minimize the potential for inappropriate or delayed treatment. We describe a practical radiological approach by using a standardized imaging protocol: standard radiographs (four views) associated with an US examination focused on seven landmarks. If there is discordance between clinical and radiological features or if the diagnosis of a disruption of the scapholunate ligament remains uncertain, additional cross-sectional imaging (MRI or CT arthrogaphy) should be performed.

Purpose: To evaluate the degree of joint distraction during direct MR arthrography with axial traction in sports injuries. To confirm the effect of axial traction on the quality of wrist opacification. Patients and methods: Seventeen patients (11 male, 6 female) underwent wrist MR arthrography without (mean: 39 years (SD 11.6))., and 20 patients (16 male, 4 female) with axial traction (mean: 28 years (SD 7.1)). Subgroups were defined according to pathology: degenerative, ligamentous, traumatic, normal (ie patients without MR-arthrography lesions). Radioscaphoid, radiolunate, lunocapitate, ulna Triangular Fibrocartilage (TFC), scapho-lunate, luno-triquetral, ulnocarpal, Carpo-Metacarpal (CMC) I and III and distal radio-ulnar spaces were measured for all patients. Differences in joint space width were compared between subgroups. Joint space opacification was subjectively scored from 0 (no opacification) to 3 (fully opacified), and compared between the groups with and without traction. Results: The difference in joint space was statistically significant ('p'